Home defibrillation: A feasibility study in myocardial infarction survivors at intermediate risk of sudden death

• Published in: The American heart journal 2006-10, Vol.152 (4), p.685.e1-685.e7
• Main Authors: Sanna, Tommaso, Fedele, Francesco, Genuini, Igino, Puglisi, Andrea, Azzolini, Paolo, Altamura, Giuliano, Lobianco, Francesco, Ruzzolini, Matteo, Perna, Francesco, Micò, Mirco, Roscio, Giancarlo, Mottironi, Pierluigi, Saraceni, Carlo, Pistolese, Michele, Bellocci, Fulvio
• Format: Article
• Language: English
• Subjects: Aged; Anxiety; Anxiety - etiology; Automation; Cardiac arrhythmia; Cardiovascular disease; Compliance; Death, Sudden, Cardiac - prevention & control; Depression - etiology; Electric Countershock; Family - psychology; Fatalities; Feasibility Studies; Female; Generalized linear models; Heart attacks; Home Nursing - education; Humans; Male; Middle Aged; Myocardial Infarction - physiopathology; Myocardial Infarction - psychology; Prospective Studies; Public health; Quality of Life; Statistical analysis; Survivors
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2006.07.008

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. 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. 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 appoinment. 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.