Home defibrillators: Ready for prime time?

Filed in archive Treatment on July 17, 2005

It appears that home defibrillators are increasing in sales:

Philips Home Medical, a division of the Royal Philips Electronics, began over-the-counter sales of AEDs on Amazon.com, Staples.com and other Web sites last year, after receiving the U.S. Food and Drug Administration's approval in September to sell them over the counter. Before Philips earned the approval, customers needed a prescription to buy the device.

"With the removal of the prescription barrier, we really became able to go after more mainstream customers," said Brian Packard, director of Philip's HeartStart Home Defibrillator business.

Since last September, Philips has sold more than 6,000 AEDs over the counter at $1,500 each, Packard said, the bulk of them through online sales.

Last year, I wrote an article looking at the evidence behind the benefit of home defibrillation. The results were marginal at best:

To put that in perspective, in a low-incidence practice (which would still have a higher incidence of sudden death than an average home), over 1900 AEDs (automatic defibrillators) would have to be purchased to treat 16 cardiac arrests over a 7 year period.

Despite any form of advertising, the prognosis of sudden cardiac death is quite poor, whether a defibrillator is available publicly or not. A retrospective study suggested that targeted public placement of AEDs increased overall survival rate from a cardiac arrest from 5.0 to 6.3 percent.

Certainly some may view any increase in survival rate to be worth $2000. However, before rushing out and buying an AED, consider the evidence. While I applaud continued public use of AEDs, I don't think it's an essential part of the well-equipped home yet. AEDs have got a ways to go before it can be compared with fire extinguishers, seat belts, and air bags.

(Wallack, "Growth expected in home defibrillators", AP/Boston Globe, Jul.17; Kevin, M.D., Sept.17,2004)