American Heart Association

Response to questions about in-hospital AED recommendations

Press Release   •   Nov 29, 2011 03:52 EST

The American Heart Association (AHA) takes issue with the article originally appearing on Nov. 14 as “Bad Shock…” by Lilly Fowler.   The article raised questions about how the AHA developed its guidelines for the use of AEDs in hospitals. The writing group for this recommendation followed AHA policy requiring a clear majority of authors to have no relationships with industry (RWI), and that no one with RWI be allowed to vote on any recommendation. The AHA has consistently enforced strong policies to guard against influence of industry in the development of our guidelines.   Our mission is to save lives. It is clear that early defibrillation saves lives. Without it, victims with shockable rhythms have virtually no chance of survival.   In 2000, evidence demonstrated that AEDs could help save lives in a variety of non-hospital settings. The AHA also found evidence showing that significant delay to defibrillation for patients having sudden cardiac arrests (SCA) in hospitals was harmful. The association recommended that hospitals focus on early defibrillation and suggested AEDs may be considered as one way to reduce the response time.   In fact, from 2000-2009, hospitals using AHA guidelines have improved SCA survival significantly, according to a study presented on Nov. 13.   A study by Chan, et al, using data from the American Heart Association’s own resuscitation registry, was published shortly after the AHA published its latest resuscitation guidelines.  It showed that 82 percent of patients who have in-hospital SCA heart rhythms can’t be helped by an electric shock. For these patients, AEDs appear to be associated with reduced survival, a finding that will require further analysis.   The American Heart Association is committed to saving lives by evaluating new, solid evidence about how best to save lives inside and outside the hospital setting, and we will continue to do so.