Should You Buy an At-Home Defibrillator?

Aug. 4, 2006 — -- To celebrate her victory over breast cancer, 35-year-old Anel Mendez decided to take the trip of her dreams -- to Paris -- with her aunt.

During a layover at the busy Los Angeles International airport, Mendez, a mother and teacher from Phoenix, heard herself paged over the airport public-alert system: She was standing at the wrong gate, and her plane was about to depart.

Mendez and her aunt made a mad dash for the correct gate, but they didn't make the flight. Mendez collapsed, suffering from cardiac arrest. Police and a woman on the scene quickly came to her rescue, delivering two shocks from a public defibrillator. It saved her life.

Mendez was so grateful that she has become an advocate for widespread access to public defibrillators.

"I learned that every minute counts, and having access to a defibrillator is crucial to saving people's lives," she said.

Clearly, defibrillators save lives. And another device, the Phillips HeartStart Home Defibrillator, promises to bring this lifesaving tool right to American homes without the need of a doctor's prescription.

But at a cost of about $1,250, is this product worth the price? It depends whom you ask.

The product is used primarily to treat victims of sudden cardiac arrest, which kills about 1,000 people a day, and half of them have no previously reported symptoms of heart disease, according to the American Heart Association. More people die from sudden cardiac arrest than from breast cancer, prostate cancer, AIDS, house fires, handguns and traffic accidents combined.

Sudden cardiac arrest is a chaotic electrical malfunction of the heart that causes it to quiver erratically and cease to effectively pump blood. An electrical shock can get the heart back on track before the brain dies. A defibrillator is recognized as the only treatment for the most common causes of this this type of sudden attack.

If caught in time, these attacks can sometimes be treated with defibrillators. However, a defibrillator is by no means the main treatment for heart attacks. For example, the late Enron founder Ken Lay was rumored to have defibrillators scattered throughout his homes and as well as on his private jet, but doctors have pointed out that there are times when an attack is too much for any treatment and the machines become useless.

So should you have your own defibrillator? Maybe, said doctors.

Dr. Ira Nash, a cardiologist at Mount Sinai School of Medicine in New York, likes the idea of defibrillators being available to the masses, but he doesn't want people to get a false sense of security.

"It's first aid, but not definitive treatment. Defibrillators can be lifesaving, but not all cardiac emergency causes are treatable in this way. These devices can discharge a shock and correct rhythm disturbances, but a massive heart attack may have other serious consequences that the device would not be able to fix," Nash said.

Nash said he made sure his house of worship had a public defibrillator installed, but he does not see a need for every person to run out and purchase one for the home.

"It's a good idea for some people who fall into the target risk group to have access to defibrillators, but this is not the type of thing that every family needs to stock like Band-Aids in a medicine cabinet," he said. "It comes down to whether you think the risk is high enough and it's worth the money to keep around. If you are at risk, you should be under treatment."

Nash explained that fatalities from sudden cardiac arrest are common, but the risk to any previously healthy individual is low. Heart disease is nearly always found in victims of sudden cardiac arrest. Those at risk for sudden cardiac arrest are frequently smokers or individuals with high blood pressure. Those so predisposed may not want to wander too far from the closest defibrillator.

The American Heart Association estimates that 40,000 more lives could be saved annually in the United States alone if automated external defibrillators, or AEDs, were more widely available and could reach victims more quickly.

Francesca Infantine, a Phillips marketing executive, said that home defibrillators are a good idea because they help overcome one of the biggest barriers to treating cardiac arrest -- time.

"With sudden arrest, [with] each passing minute, the chances of survival fall at a rate of 10 percent. The average response time for emergency personnel in a typical community is nine minutes, so time can run out quickly," she said, adding that many people experience cardiac arrest at home, with someone nearby who could potentially offer help.

To keep it as simple as possible, the HeartStart home defibrillator was designed specifically for the home user who will not have time to call technical support for help in working a complicated machine while a loved one goes into arrest.

I tried a demonstration of the device, and found it simple to use: Six instructional steps were delivered in a clear calming voice (the audio is integrated into the device), which coached me to proceed at my own pace, to alert 911, remove the patient's shirt, peel open the two adhesive pads, and place the pads on the victim (guided by a clear infographic). If necessary, I would have been instructed to press the orange button to deliver the shock of 150 joules of energy, and ideally shock the heart back into proper action. Additionally, the rescuer is coached through very important CPR procedures while awaiting professional help.

Of special concern to the Federal Drug Administration was the product's safety, since the product is being sold as an over-the-counter device. So, once applied to the body, the pads begin to measure the pulse and will only administer a shock if necessary, ruling out the chance for misuse or accidents.

Defibrillators are getting easier to find in many public venues. For example, Phillips' medical unit already has a robust defibrillator business, selling more than 300,000 industrial versions a year to places like sporting arenas, athletic clubs, airports, offices and school districts.

Every public school in New York, Los Angeles and Chicago is required by law to have a defibrillator on-site, and the individual administering the treatment is shielded from liability by "good Samaritan" laws.

Is it time for every household to purchase one? Dr. Nash leaves it up to each individual.

"Personally, I am not in the market for a home defibrillator, but if there is someone in the household at risk, or money is not an object, there is very little reason not to get one."