Scant benefit found in home defibrillators

April 02, 2008|By New York Times News Service

Researchers had bad news yesterday for makers and buyers of portable devices that deliver electrical shocks meant to revive victims of heart seizures. In the first major study of their use in household settings, the researchers found no evidence that the devices produced significant lifesaving benefits.

The equipment, originally designed for ambulance crews, has been marketed to health-conscious consumers as the latest safety feature for their homes. But the study of more than 7,000 heart patients concluded that patients in homes equipped with the devices died at the same rate as those without it.

In reporting their findings at a cardiology meeting in Chicago and online in The New England Journal of Medicine, the researchers noted that the lifesaving potential of the devices, known as automated external defibrillators, is well-established in hospitals, emergency vehicles and in public settings like airports and casinos. But in contrast to the typical household, such public locations attract thousands and in some cases millions of people a year, and employees who are trained to use the defibrillators are typically close at hand.

The home study, sponsored by the government but partly financed by industry, followed the patients for an average of three years. The death rates from all causes and from heart problems in the group given defibrillator kits - and training in how to use them - were lower than expected but virtually identical to the rates for the group that did not receive the equipment.

Fourteen patients treated in the three-year study suffered the specific heart rhythm malfunction that the defibrillator could combat. Of that group, four survived to be released from the hospital.

The authors of the online report said that the result was "fortunate" for the handful of survivors but that any program to get defibrillators into people's homes would be "an inefficient strategy in public health terms."

Dr. David Callans, a professor of cardiovascular medicine at the University of Pennsylvania School of Medicine who was chosen by the journal to write an accompanying commentary, was blunter about consumer investments in the devices, which sell for as much as $1,500.

"It's a great example of what is wrong with American health care," Callans said in a telephone interview. Home defibrillator kits might make sense only in rare cases, such as those of children at risk of cardiac arrest who have multiple caregivers and are too small to have an implanted defibrillator, he said.

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