Home defibrillation: a feasibility study in myocardial infarction survivors at intermediate risk of sudden death.
BACKGROUND
Out-of-hospital cardiac arrest occurs at home in 65-80% of cases and is often witnessed. We designed a study to explore the feasibility of a home defibrillation program (a) evaluating the retention of cardiopulmonary resuscitation and automated external defibrillators (AED) use skills (BLSD) (b) assessing the impact on anxiety, depression, and quality of life and (c) recording the critical issues emerging from program implementation.


METHODS
Thirty-three post-myocardial infarction patients and their 56 relatives received BLSD training and an AED. Assessment of BLSD skills, levels of anxiety, and depression and quality of life were scheduled every 3 months for 1 year or until a common stopping date.


RESULTS
Overall BLSD score was 26 +/- 3 at baseline vs. 22 +/- 5 at 3 months (P < .0001), 21 +/- 6 at 6 months (P < .0001), 22 +/- 4 at 9 months (P < .0001) and 23 +/- 5 at 12 months (P = .001). Conversely, the BLSD component AED use" remained stable throughout the study. Quality of life, anxiety, and depression scores remained constant. Compliance to BLSD retraining sessions and AEDs checks decreased over time and was influenced by a concomitant clinical appointment.


CONCLUSIONS
BLSD performance of families of post-myocardial infarction patients decreases over time, even though the ability to operate AEDs appears to be the least affected component. Compliance with retraining sessions and AED checks declines over time and is improved if they are combined with clinical appointments. The implementation of a home defibrillation program does not affect anxiety, depression, or the quality of life.
Sanna
Tommaso
T
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy. tommaso.sanna@rm.unicatt.it
Fedele
Francesco
F
Genuini
Igino
I
Puglisi
Andrea
A
Azzolini
Paolo
P
Altamura
Giuliano
G
Lobianco
Francesco
F
Ruzzolini
Matteo
M
Perna
Francesco
F
Micò
Mirco
M
Roscio
Giancarlo
G
Mottironi
Pierluigi
P
Saraceni
Carlo
C
Pistolese
Michele
M
Bellocci
Fulvio
F
D000368:Aged; D001007:Anxiety / Q000209:etiology; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D003863:Depression / Q000209:etiology; D004554:Electric Countershock; D005190:Family / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006701:Home Nursing / Q000193:education; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D017741:Survivors