Home Use of Automatic External Defibrillators to Treat Sudden Cardiac Arrest

Study Overview
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Brief Summary
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To compare home use of an automatic external defibrillator (AED) to the use of local emergency medical system in treating survivors of sudden cardiac arrest.

Detailed Description
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BACKGROUND: Sudden cardiac arrest (SCA) occurs every two minutes throughout the United States, with more than 70 percent occuring at home. Because survival falls 10 percent per minute over the first ten minutes, it is imperative to defibrillate as soon as possible. Public efforts cannot provide defibrillation fast enough in most cases. Physicians believe the initial shock is best done using readily available AEDs by family members who are only seconds from their loved one. DESIGN NARRATIVE: This study tests the central hypothesis that providing an AED for home use will improve survival beyond that achieved from the typical response to sudden cardiac arrest. An estimated 7,000 people who have had an anterior myocardial infarction will be randomly assigned to one of two groups: 1) a standard response to sudden cardiac arrest, entailing calling an emergency medical service (EMS) system and performing CPR, or 2) the addition of a home AED to the standard response. The standard response will be augmented and standardized by the provision of a video on how to respond to sudden cardiac arrest and how to perform CPR. The goal for the standard response will be immediate notification of EMS and prompt CPR. The goal for the AED group will be to shock the cardiac arrest victim up to three times immediately, if indicated by the AED, and call EMS and perform CPR as soon as possible and preferably within two minutes of collapse. Participants will be enrolled for more than two years and followed for an additional two years. The study will be performed at 200 cardiology clinics.

Official Title
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Home Automatic External Defibrillator Trial -- HAT

Conditions
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Cardiovascular Diseases, Myocardial Infarction, Heart Diseases, Death, Sudden, Cardiac

Intervention / Treatment
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* Other: Cardiopulmonary Resuscitation
* Device: Automatic External Defibrillation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of anterior myocardial infarction Live-in spouse or companion willing to administer CPR or AED therapy plus CPR Exclusion Criteria: Existing implantable cardiac defibrillator or AED Current candidate for an implantable cardiac defibrillator Current Do Not Resuscitate orders

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: 1<br>Intervention: Immediate notification of EMS by telephone and prompt initiation of CPR, in accordance with published Basic Life Support guidelines. | Other: Cardiopulmonary Resuscitation<br>* Immediate notification of EMS by telephone and prompt initiation of CPR, in accordance with published Basic Life Support guidelines<br>|
| Experimental: 2<br>Use of the AED first, in accordance with published guidelines for AED use, followed by a call to EMS and perform CPR as in the control group. | Device: Automatic External Defibrillation<br>* Use the AED first, in accordance with published guidelines for AED use, followed by a call to EMS and perform CPR as in the control group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| All-cause mortality (measured throughout the study) |  | Five interim analyses of the data were performed and reviewed by the DSMB | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival in the home from cardiac arrest and survival with AED use. |  | Five interim analyses of the data were performed and reviewed by the DSMB | 
| Quality of life of the participants and their spouses (measured throughout the study) |  | Five interim analyses of the data were performed and reviewed by the DSMB | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CPR, AED