UPDATED: Automatic defibrillators may be less effective

In 2000, hospitals welcomed automatic defibrillators to help save patients who experienced sudden cardiac arrest. These new devices were purchased (relatively) cheaply and expected to save the lives of thousands of patients because they worked automatically. However, new evidence suggests this hope is misplaced, and that some members of the American Heart Association committee, which made the recommendation to purchase the machines, had ties to companies that manufactured automatic defibrillators.

LOS ANGELES, CA (Catholic Online) - They were believed to bring swift emergency help, but statistics show that patients treated with the automatic defibrillators had a greater risk of death than those who were treated with conventional devices. 

The new automatic defibrillators are almost ubiquitous and found throughout hospitals across the US, but they are saving fewer lives than traditional machines. The difference is about 3 percent, with the study showing those treated with automatic devices surviving about 16.3 percent of the time versus those treated with manual equipment having a survival rate of 19.3 percent; perhaps only a single digit in number, but over a decade that figure translates into thousands of lives. 

The agency, FairWarning has done an independent review of the committee recommendation and found that recommendation was made without completing critical clinical research on the machines. Instead of relying on research, members of the committee made their recommendation based on the hypothesis that they would save more lives because they required less skill to operate than traditional machines. That meant less-skilled personnel could use the machines without the need of a highly-trained nurse or physician to do the defibrillation. What wasn't foreseen was that many less-skilled nurses would find using the new machines intimidating and would balk at using any defibrillator, including the automatic equipment.

Exacerbating the concern is that automatic defibrillators require longer "hands-off" interruptions to make critical readings, which means lost seconds of CPR. In some cases, those lost seconds can mean the difference between life and death. 

Critics say the machines remove a critical human decision-making element from the defibrillation process that can sometimes jeopardize patients' lives.

This is in addition to the fact that the machines have reliability issues. At least 1,000 deaths were associated with equipment that failed, including some instances where it inexplicably shut down altogether in the middle of an emergency. Manufacturers have blamed lack of maintenance for some of these cases, as the machines require periodic attention. 

The committee making the recommendation may also be part of the problem. At least a quarter of the people on the Heart Association committee had connections with companies that made the machines. 

Still, the American heart association defends the decision. Mary Hazinski, a member of the 2000 decision-making committee said that Heart Association policies "prevented undue industry influence on its guidelines recommendations." She added the recommendation was, "very carefully considered and based on the evidence available at the time."

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Nobody questions the new equipment has been faster and easier to use. Unfortunately, the statistics show the equipment is prone to failures, operator mistakes, and is not always the best option for a cardiac arrest. 

According to Advanced Medical Technology Association, companies are cooperating with the FDA to improve the safety of the devices, and the FDA continues to recommend their use. 

The Heart Association is scheduled to review their recommendation in 2015.

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