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First At-Home Defibrillator Approved

While cardiopulmonary resuscitation, or CPR, can buy victims time by keeping blood flowing, only the electrical jolt from a defibrillator can restart the heart.

Every year, about 220,000 Americans collapse and die from cardiac arrest. Every minute spent waiting for paramedics to arrive with a defibrillator lowers the chance of surviving a heart attack by 10 percent. So portable versions of the electric shock paddles now are common everywhere from casinos to airplanes to amusement parks. While the machines require no medical expertise, a staff person trained to use the machine usually administers the shocks.

Some 70 percent of cardiac arrests occur in the home. While they can strike at any age, the average victim is a man in his 60s, meaning the main users of at-home defibrillators likely will be older women trying to save their husbands, Dr. W. Douglas Weaver told the Associated Press. Conversations with widows convinced Weaver, the cardiovascular chief at Detroit’s Henry Ford Hospital, that they need that chance.

“Many of them felt it was such a helpless situation to be able to do nothing, that even trying and not succeeding would have been better than not knowing what to do at the time,” he said.

The Philips Electronics’ HeartStart Home Defibrillator requires a doctor’s prescription, comes with a recommendation for potential users to seek training on using the device and is not a substitute for paramedics — people are supposed to call 911 before grabbing the defibrillator.

The HeartStart “talks” users through each step of resuscitation with instructions revamped to be simple enough for a sixth-grader to understand. Philips provided the FDA with small studies showing that people who had never seen the device could follow the directions.

The home defibrillator does not shock if it detects a heartbeat, so there is no danger of accidentally electrocuting someone. The at-home version will also beep when the battery gets low, much like a smoke alarm.

The American Heart Association is holding back on recommending the at-home defibrillators until research shows they actually save lives, AHA spokesman Dr. Vinay Nadkarni told the AP. But the AHA does support the current program of placing defibrillators in public places.

Studies of laymen’s use of defibrillators in public buildings are mixed on whether the devices increase survival rates significantly more than performing CPR until paramedics arrive. The National Institutes of Health is about to enroll 7,000 people at high risk of cardiac arrest into a study that examines whether people panicked by a loved one’s collapse will be able to use the defibrillator effectively. For the study, the family members of those at risk for a heart attack will be trained in CPR, and half also will be given an at-home defibrillator. Results won’t be known for up to four years.

For clues in the meantime, the FDA has ordered Philips to track use of the HeartStart during its first year of sales.

Philips will begin selling the home defibrillator — which costs nearly $2,300 — directly to patients with a prescription via the Internet and telephone. CVS pharmacies will begin stocking the machines early next year. It’s not yet clear if insurance companies will pay for the at-home device.

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