Automatic external defibrillator: key link in the chain of survival.
BACKGROUND
Sudden cardiac death is a major health problem. Worldwide success of resuscitation from out-of-hospital cardiac arrest is modest, with 5% to 10% survival to hospital discharge.


RESULTS
In the chain of survival, early defibrillation (goal <5 min after collapse) is a major determinant of successful outcome of resuscitation. This goal is rarely achieved, but the automatic external defibrillator (AED) is a promising tool for lay defibrillation. The AED is a safe and effective device with nearly 100% accurate detection of ventricular fibrillation and nearly 100% accurate detection of a nonshockable rhythm. A large uncontrolled experience suggests improved outcome in nontraditional responders such as police. Controlled studies of community application of the AED are under way.


CONCLUSIONS
The AED is a promising tool in the fight against sudden cardiac death and should be studied and supported by all scientists involved, including electrophysiologists.
Koster
Rudolph W
RW
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. r.w.koster@amc.uva.nl
D016887:Cardiopulmonary Resuscitation; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004554:Electric Countershock / Q000295:instrumentation*; D017408:Guidelines as Topic; D006801:Humans; D013534:Survival