Published 23 March 2009, doi:10.1136/bmj.b874
Cite this as: BMJ 2009;338:b874

Head to Head

Should doctors recommend automated external defibrillators for use at home after myocardial infarction? Yes

¹ University of New South Wales and St Vincent’s Clinic, 438 Victoria Street, Darlinghurst, NSW 2010, Australia

Should people who risk of reinfarction have defibrillators available at home? Michael F O’Rourke thinks that enthusiasm is an important factor (doi:10.1136/bmj.b874); Mathew Hutchinson and David Callans say at home defibrillators do not save additional lives (doi:10.1136/bmj.b876)

The first 150 words of the full text of this article appear below.

Ventricular fibrillation causes most of the sudden non-traumatic deaths in Western society—up to 400 000 deaths a year in the United States alone.¹ Most deaths occur in people without known heart disease, but many occur in people with known coronary artery disease.¹ Defibrillators in aircraft, airports, railway stations, sports stadiums, police patrol cars, gymnasiums, and various public places are designed for the population at large,² and in these locations their use is regarded as cost effective.³ Like fire extinguishers, they seem to be for use in a rare emergency.

Guidelines for the implantation of defibrillators now include patients of all ages whose left ventricular ejection fraction is less than 30% but who have a prospect of living without major cardiac disability for two years.⁴ Implantation of a defibrillator is encouraged by manufacturers and by proceduralists, who fear that deviating from guidelines may be a cause for legal action. Together with . . . [Full text of this article]

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Should doctors recommend automated external defibrillators for use at home after myocardial infarction? Yes

Michael F O’Rourke
BMJ 2009 338: b874. [Extract] [Full Text]

Should doctors recommend automated external defibrillators for use at home after myocardial infarction? No

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BMJ 2009 338: b876. [Extract] [Full Text]

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