Still waiting for a break over 2.50! The chart has started to make a new upward trend, but it hasn't broken resistance and the downtrend yet. I'm still optimistic.
From the WSJ:
March 31, 2003
SPECIAL REPORT: TECHNOLOGY
Taking Technology to Heart
A portable defibrillator in every home? Advocates say that's where we're heading
By DANIEL ROSENBERG
DOW JONES NEWSWIRES
Can a home defibrillator save your life?
The portable devices that shock the heart back into a proper beat after sudden cardiac arrest already have proved their mettle in public places such as airports and casinos. Studies show their use has resulted in major improvements in mortality rates.
Now, the automated external defibrillators, or AEDs, are making their way to the home market. One manufacturer has begun producing a model specifically for residential use, and sales have begun to accelerate -- even as many in the medical industry continue to debate whether use of the home device is a viable way to save lives.
The Importance of Speed
Around 70% of cases of sudden cardiac arrest -- which is caused by an abnormal heart rhythm called ventricular fibrillation -- occur in or near the victim's home. And the chance for survival falls 7% to 10% for every minute of delay without defibrillation, according to the American Heart Association. Brain death starts to occur four to six minutes after sudden cardiac arrest and approximately 95% of victims die before reaching the hospital. Sudden cardiac arrest causes around 250,000 deaths in the U.S. each year, or 680 a day. Doctors say thousands of those deaths could be prevented by early defibrillation.
And many in the medical industry say AEDs could do just that. They say the devices' ease of use and portability make them indispensable for people with a high risk of a heart attack. You simply need to place two adhesive pads, connected to the book-size device by wires, on a person's chest and then press a button to send a shock to the heart. These medical experts even see a day when every new home and car will come with an AED.
Joseph Soffer, a cardiologist in Bryn Mawr, Pa., recently bought a defibrillator for his 65-year-old father-in-law, a heart-attack survivor. "My father-in-law is at very high risk for sudden cardiac death," Dr. Soffer says. "He had a heart attack 10 years ago. He's overweight. He has high blood pressure and diabetes. So I felt strongly that this was a no-brainer for me."
Others, however, remain skeptical until more information is available. The National Institutes of Health is sponsoring a study of 7,000 post-heart-attack patients in five countries, half of whom will receive home defibrillators. But the study began enrollment in January and results are five years away.
"Across the board, there's not yet enough information to endorse that everyone should have a home defibrillator," says Vinay Nadkarni, chairman of emergency cardiovascular care at the American Heart Association, which, for now, doesn't endorse the concept. "It may be like a smoke detector -- where it's a very desirable thing to have. But until there's more data, we have to reserve judgment and endorsement." Dr. Nadkarni does endorse wider education about the devices.
Art Kellerman, chairman of the Department of Emergency Medicine at Emory University School of Medicine in Atlanta, says AEDs are a wonderful technology, and they've proved to be lifesavers in public places. And studies may, indeed, prove that they save lives in homes as well. But he notes that home AEDs may actually hurt victims' chances for survival. For instance, the victim's family members might grab the AED instead of immediately calling 911. Dr. Kellerman adds that half the smoke detectors in the U.S. aren't functional because people forget to change their batteries. And the same could happen to the lithium-battery-operated AEDs.
Sticker Shock?
What's more, the cost -- $2,000 to $3,000 -- is prohibitively expensive for many. Insurance doesn't cover the cost of the device. And those who can afford it still need a prescription from a doctor.
Still, the market is growing. Philips Medical Systems of the Netherlands has sold 700 home AEDs since introducing a home model last November. That compares with total industry sales to the home market of 150 in 2001 and 168 in 2000.
Philips Medical, a part of Royal Philips Electronics, hopes to sell about 5,000 such units for home use this year and to grow that market about 50% a year. The company expects $10 million in sales from the home market in 2003. The devices, which cost $2,295, are available through the company and some CVS Corp. pharmacies.
"Ultimately our goal is: You have a fire extinguisher and a smoke detector, and someday you'll have a defibrillator," says Deborah DiSanzo, vice president and general manager for cardiac resuscitation at Philips Medical. "As people are educated, we'll see them in every home." She thinks eventually they'll be cheaper than home computers.
Dr. Soffer ordered an AED from Philips. The family watched the instructional video that came with the product, and now the three-pound AED resides in his in-laws' bedroom.
It's also portable. "They take it everywhere -- in their car, when they come to my house," Dr. Soffer says. "It's light; it's easy to take. Heaven forbid you don't have it with you when you have a cardiac arrest."
Dr. Soffer regrets that defibrillators cost so much as to put them out of reach for many people, and that he needed to write a prescription for his father-in-law to get one. He thinks costs will come down, and that eventually the government will allow people to buy the devices without consent from a doctor.
Medtronic Inc., Minneapolis, and Cardiac Science Inc., Irvine, Calif., two other companies that manufacture AEDs, won't make specific forecasts about home sales, but both also expect the market to expand. These devices can only be purchased directly from the companies for $2,995.
"It's a nascent market, but it has huge potential," says Raymond Cohen, president and chief executive officer of Cardiac Science. He says his company sees dozens of people a month buying AEDs for the home.
As the individual home use of AEDs continues to be debated, some communities are taking matters into their own hands. They're banding together to buy the devices, with a neighborhood doctor writing a prescription. For instance, Neighborhood Heart Watch, a nonprofit group of concerned citizens in Indianapolis, has placed defibrillators in public areas, including in the gateway to a gated residential community. Residents have learned CPR and how to use the devices, and agree to be on call in case of emergency.
Douglas Zipes, director of the Krannert Institute of Cardiology in Indianapolis and an organizer of Neighborhood Heart Watch, says he would "like to see it spread across the U.S. The response we've gotten has been extremely gratifying."
Dr. Nadkarni of the American Heart Association thinks there may be a place for AEDs in towns or rural areas with slow emergency-vehicle response times. But he believes people living in an area with rapid emergency response would be better off doing CPR on the victim and calling an ambulance.
And even a strong advocate like Dr. Zipes has some concerns about placing AEDs in the home. Not long ago, his wife ruptured her appendix and he found himself having to treat her. He was able to, but even as a doctor he found himself shaken by the experience.
"It's an awesome responsibility needing to save the life of a loved one," Dr. Zipes says. "There is a very strong emotional aspect to saving one's spouse, and whoever accepts the responsibility to have an AED in the home needs to understand that."
-- Mr. Rosenberg is a staff reporter of Dow Jones Newswires in Chicago. |
