Munther Homoud, MD
In stable patients at increased risk for sudden cardiac arrest, does having an automated external defibrillator (AED) in the home reduce mortality?
Randomized controlled trial (Home Automated External Defibrillator Trial [HAT]).
Blinded (outcome adjudication committee).*
Median 37 months.
178 clinical sites in the US, Canada, Australia, the UK, New Zealand, the Netherlands, and Germany.
7001 patients (median age 62 y, 83% men) who had had anterior wall myocardial infarction, were not candidates for implantable cardioverter-defibrillator (ICD) therapy, and had a spouse or companion at home who was willing and able to perform the study interventions.
Provision of an AED for home use (n = 3495) or no AED (n = 3506). In case of suspected sudden cardiac arrest, the companion in the control group was to immediately telephone emergency medical services and start cardiopulmonary resuscitation (CPR); in the AED group, the companion was to use the AED first, then proceed as in the control group. Companions received instructional videos for standard CPR (both groups) and AED use (AED group).
Death from any cause, death from sudden cardiac arrest, and survival (≥ 48 h) from witnessed sudden cardiac arrest at home.
100% (intention-to-treat analysis).
Having an AED available in the home did not reduce all-cause mortality or death from sudden cardiac arrest (Table). Of patients who had witnessed sudden cardiac arrest at home, groups did not differ for survival: 7/34 (21%) in the AED group compared with 6/37 (16%) in the control group.
In stable patients at increased risk for sudden cardiac arrest, having an automated external defibrillator in the home did not reduce mortality more than conventional resuscitation methods.
Automated external defibrillator (AED) in the home vs conventional resuscitation methods (control) in patients at risk for sudden cardiac arrest‡
‡Abbreviations defined in Glossary. RRR, RRI, NNT, NNH, and CI calculated from data in article.
Homoud M. An automated external defibrillator in the home did not reduce mortality in patients at risk for cardiac arrest. Ann Intern Med. 2008;149:JC2–9. doi: 10.7326/0003-4819-149-4-200808190-02009
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Published: Ann Intern Med. 2008;149(4):JC2-9.
Cardiology, Emergency Medicine, Rhythm Disorders and Devices.
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