STORY BYThis Valentine’s Day, forget the cutesy cards, stuffed animals and chocolate. If you really want to get your loved one’s heart started, gift wrap an automatic external defibrillator. More than a year ago, the U.S. Food and Drug Administration sparked a debate in the medical community when it approved the first automatic external defibrillator (AED) specifically designed for home use without a prescription.
Those who can afford more than $1,000 for the battery-powered device could use it to help restore a normal heart rhythm in someone who is experiencing sudden cardiac arrest. According to the "Heart Disease and Statistics 2006 Update", published in Circulation Magazine by The American Heart Association, cardiovascular disease as an underlying cause accounted for 1 of every 2.7 deaths in the United States in 2003. This adds up to about one heart-related death every 35 seconds, and claims more lives than cancer, chronic lung disease, accidents and diabetes mellitus—together.
The AED is designed though to resuscitate victims of sudden cardiac arrest—those whose hearts have suddenly stopped and have ceased the mechanical job of pumping blood through the body. A huge portion of sudden cardiac arrests result from an often-fatal disruption in electrical current in the chambers of the heart. Without coherent electrical function, the heart can shut down.
Proponents say the HeartStart Home Defibrillator device, which delivers an external electric shock through the patient’s chest to correct the most common lethal arrhythmias, such as ventricular tachycardia, could save thousands of lives.
Others have argued that such a device may delay calls to 911 and, as a result, actually hurt the patient’s chance of survival. Also, there is concern that people may rely too heavily on the device’s capabilities and not take the time to learn their own life-saving skills, such as CPR.
We asked two experts at The University of Texas Medical School at Houston to weigh in on the value of external defibrillators – both in the home and in public places. Here’s what they have to say.
Anne Dougherty, M.D., professor of cardiology and cardiac electrophysiology specialist at The University of Texas Medical School at Houston, says AEDs should be in every public place, and probably on every floor of every public building. Having the device at home could be a benefit, too, she says.
“AEDs can make a huge difference in outcomes,” she says. “Every second – every minute – counts when someone has sudden cardiac arrest. For every minute the heart is stopped, you lose about 10 percent of your chances of survival.”
Having an AED in the home, where most sudden cardiac arrests occur, could help get the patient’s heart restarted in those critical moments before an ambulance arrives, Dougherty says.
An important feature of the AED is its ability to assess whether the patient is indeed in cardiac arrest and needs an electric shock to restore regular heartbeat, she says.
The device has two conductive adhesive pads connected to the device that are attached to the patient’s bare skin. When the pads make contact with the skin, the device analyzes the patient’s heart rhythm to determine whether the user should administer a shock.
It can be used on adults or children 8 years or older, who weigh at least 55 pounds, and do not respond when shaken and are not breathing normally.
“If you have the means to buy one, I think it’s a really good thing,” Dougherty says. “It is extremely user-friendly. It has labels and verbal commands that talk you through what to do. You can take a five-minute, in-service training to learn how to use it. Even a child can easily learn to operate the AED.”
Arlo Weltge, M.D., MPH, clinical associate professor in the Department of Emergency Medicine, says an AED is probably not appropriate for every household, but it may be of benefit in the homes of patients with heart disease who do not already have an implanted defibrillator.
He cautioned that the device alone is not sufficient. “It requires knowledge of CPR by those in the home,” Weltge says. “It should not delay CPR or calls to 911, and the device location and how to use it should be made available to all those in the home.”
If someone experiences sudden cardiac arrest, call 911 first. Then go get the external defibrillator, Weltge says.
With or without an at-home defibrillator, Weltge says, smart heart health and emergency preparedness are the best methods of dealing with sudden cardiac arrest. “Avoid a heart attack by not smoking,” he says. “Treat high blood pressure and high cholesterol, and do exercise regularly.”
Take basic life support and CPR classes from the American Red Cross or the American Heart Association. “Everyone should know how to call 911 and respond to an emergency in the home,” Weltge says.
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Dr. Anne Dougherty is a professor of cardiology and cardiac electrophysiology specialist at the UT Medical School.
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Dr. Arlo Weltge is a professor of cardiology and cardiac electrophysiology specialist at the UT Medical School.
See Dr. Weltge also at:
Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
