Home AED Devices Enhance Survival in Shockable Cardiac Arrest, But Cost Remains a Barrier
Recent research has highlighted the potential benefits and financial challenges of placing automated external defibrillators (AEDs) in private residences for individuals experiencing cardiac arrest with a shockable rhythm. The study, published in a leading medical journal and presented at a major European cardiology conference, analyzed data from a large cohort of cardiac arrest cases in the United States between 2017 and 2024.
Cardiac arrest is a critical medical emergency characterized by the sudden loss of heart function. A shockable rhythm, such as ventricular fibrillation or pulseless ventricular tachycardia, can potentially be reversed by delivering an electric shock to the heart using a defibrillator. AEDs, which are portable and user-friendly devices, have become increasingly available in public spaces. The debate continues over their utility and cost-effectiveness in private homes, where most out-of-hospital cardiac arrests occur.
The research team evaluated over 580,000 cardiac arrest cases, with a median patient age of 65 years and a majority being male. The investigators used a robust statistical method to compare outcomes between cases where an AED was applied before emergency services arrived and those where it was not. Their findings demonstrated that for patients with a shockable rhythm, the use of an AED at home was associated with a significant improvement in survival rates to hospital discharge. Specifically, the likelihood of survival increased by approximately 26% compared to cases without an AED intervention. However, this improvement was not observed in cases involving nonshockable rhythms, where defibrillation is not indicated.
Despite the clear clinical benefits, the study also addressed the economic aspect of widespread AED deployment in private residences. The cost-effectiveness analysis revealed that placing an AED in every home would not meet commonly accepted thresholds for healthcare spending efficiency at current device prices. The incremental cost per quality-adjusted life-year (QALY) gained was substantially higher than the standard benchmark used by health economists. According to the analysis, home AEDs would only be considered cost-effective if the annual risk of cardiac arrest in a household exceeded 1.3%, or if the purchase price of the device dropped below $65--both scenarios that are currently uncommon.
The findings suggest that while AEDs in private homes can save lives in specific cardiac emergencies, the financial investment required is considerable under current market conditions. The study recommends that indiscriminate placement of AEDs in all residences is not justified from a cost-effectiveness standpoint. Instead, targeted deployment in high-risk households or substantial reductions in device costs could make home AED programs more viable in the future.
The implications of this research are significant for policymakers, healthcare providers, and consumers. Efforts to improve survival from out-of-hospital cardiac arrest may benefit from a balanced approach that prioritizes evidence-based deployment of AEDs, public training in their use, and continued innovation to reduce device costs. Meanwhile, public access AEDs in community locations remain a proven strategy for improving outcomes in sudden cardiac emergencies.