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    A Lifesaving Machine Over the Counter?

    FDA Panel OKs No-Prescription Sales of Home Defibrillator

    A Zap in Time continued...

    And that's not all. The machine then instructs the user on how to give CPR.

    Why not just call 911? That's what's controversial.

    Those who favor home defibrillators point out how little time there is to waste. According to a recent study, a person who collapses from a heart attack has only a 12% chance of survival if not defibrillated in five minutes. Family members might be able to deploy an AED before emergency help could arrive.

    On the other hand, home defibrillators might make real families in a real emergencies waste precious time, says Arthur Kellermann, MD, MPH, chairman of the department of emergency medicine at Atlanta's Emory University.

    "Having an AED in the home might make a person less likely to call 911 or go to the ER, because of embarrassment they might be wrong about the signs of a heart attack," Kellerman says. "It might make a family focus their efforts on frantically looking for the thing -- 'Is it under the bed? In the closet?' -- rather than calling 911. We don't know. That's why more studies are needed."

    Cost Is an Issue

    Kellerman argues that the price of the machines ($1,995 according to a toll-free number listed on the HeartStart web site) is better spent elsewhere.

    "The odds you will ever need it is remote. Buying a home defibrillator is like buying a very expensive lottery ticket," Kellerman says. "It is a huge family expense with a very low likelihood of a patient ever seeing a benefit."

    But what if a patient told him he really wanted a home defibrillator?

    "If a patient said, 'I want to improve my chances of surviving a heart attack,' I'd say, 'Your best chance is not to have a heart attack in the first place," Kellerman says. "If you have $2,000 burning a hole in your pocket, join a health club; get help stopping smoking; get help lowering your cholesterol. Sure, AEDs have saved hundreds of lives. But we have saved hundreds of thousands of lives with primary prevention of heart disease. And we don't know whether having an AED in the home will make a family less interested in prevention."

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