Heart Machine Could Be Coming to a Crowded Area Near You

From the WebMD Archives

May 9, 2000 (Washington, D.C.) -- When lawyer Robert Adams' heart essentially stopped beating in Grand Central Station, transit officials saved his life with an automated external defibrillator that had arrived just the day before for public emergencies.

The laptop-sized device analyzes the rhythm of the heart beats through pads that attach to a patient's chest, and can deliver shocks that can restart the heart if it goes into an abnormal rhythm or suddenly stops beating. This emergency is called cardiac arrest and is different from a heart attack, which occurs when a blood vessel supplying blood to the heart is blocked. Some 250,000 Americans die from sudden cardiac arrest each year, accounting for close to 25% of all deaths in this country.

"I'm here because of that machine," Adams testified at a congressional hearing, summoning his young son to his side, in emotion-choked testimony Tuesday that stirred a rare roomful of applause.

But others haven't been so fortunate, including a military officer who died in the Pentagon, which was unequipped with a defibrillator.

And there's the case of Kimberly Anne Gillary, who at age 15 suffered cardiac arrest at her high school pool. She was one of three students in southeast Michigan to suffer such a fate and die so far this year. "It should really be a concern for parents, for everyone. It can happen," says her father, Randy Gillary.

Since his daughter's death, Gillary has campaigned to get a defibrillator in every school in his state. So far, two have been placed in schools with two more on the way.

Rep. Cliff Stearns (R, Fla.) noted that the top five sites where cardiac arrests occur are airports, county jails, shopping malls, sports stadiums, and golf courses. The benefit of the defibrillators is that most people can use it with minimal training.

Health groups, including the American Heart Association, believe that greater public availability of defibrillators would save tens of thousands of lives. At today's House subcommittee hearing, American Red Cross official Scott Conner said, "On-site and widespread deployment of [defibrillators] is the most feasible method" to restoring an individual's heart beat in the critical first minutes of sudden cardiac arrest.

Unfortunately, many highly trafficked locations do not maintain the devices, due to a combination of cost and legal concerns.

In a move to help make these defibrillators potentially as common as fire extinguishers, a House subcommittee on Tuesday unanimously approved Stearns legislation, which would require the federal government to establish standards to equip its buildings with the devices.

The bill also would free laypersons, or "Good Samaritans," to operate the devices in emergencies without the fear of a lawsuit. Similar legislation has been introduced in the Senate by Slade Gorton (R, Wash.). "This has the potential to save many lives," said Rep. Fred Upton (R, Mich.).

Legal expert Richard Lazar told the subcommittee that he was unaware of any lawsuits in this country involving improper use of a defibrillator. But Rep. Greg Ganske, MD, (R, Iowa) noted that the public's perception is different.

Rep. Michael Bilirakis (R, Fla.), chairman of the House health and environment subcommittee, tells WebMD that the legislation is likely to face approval by the House Commerce Committee, before the full House can consider the measure later this year.

Bilirakis also acknowledges that money worries remain as an impediment to broad availability for the devices. The defibrillators cost around $3,000 each, and about four hours of training is required to learn their proper use.

Widespread implementation of the devices also has critics. "It's an awful expense for a little benefit," says David Wright, MD, an emergency room physician at Emory University Medical Center in Atlanta. Instead, he suggests using the money for such things as the screening of student athletes. He also notes the defibrillators aren't idiot proof, but instead are only easy when one already knows what to do -- especially in a frantic situation.