TItle of Trial
Public Access Defibrillation (PAD) trial

Date and Location of Presentation
Presented at the November 2003 American Heart Association Annual Scientific Session in Orlando, Florida

Date and citation of primary publication(s) or References
Not Published

Purpose of the Trial
The goal of the study is determine whether training laypersons to use automatic external defibrillators (AED) could increase survival for victims of out-of-hospital cardiac arrest beyond training to call 911 or perform cardiopulmonary resuscitation (CPR).

Study Category
Sudden Cardiac Death & Syncope

Patient Population
Victims of out-of-hospital cardiac arrest

Inclusion Criteria

Patients

• Age > 8 years
• Confirmed, treatable out-of-hospital cardiac arrest

Rescue Units

• > 250 persons, age > 50 years, on-site > 16 hours/day or a history of > 1 witnessed out-of-hospital cardiac arrest

Exclusion Criteria

Rescue Units

• Existing or prior public access defibrillation program
• Very fast response rate for defibrillation
• Trained medical personnel

Study Design
Randomized, multinational, community-based trial of CPR alone versus CPR+AED

Primary Endpoints
Survival to hospital discharge

Secondary Endpoints
Adverse events such as inappropriate shocks

Baseline Characteristics
Patient number: 232 patients and 19,762 volunteers in 993 units in 21 US and 3 Canadian sites
Mean Age: mean age of patients is 70 years
Gender: % female; not specified

Time to Follow-up
Follow-up until hospital discharge

Results
The number of out-of-hospital cardiac arrests treated with CPR+AED was higher than in the CPR-only group (129 with CPR+AED vs. 103 CPR only), with the differences occurring in the public (96 vs. 69), rather than residential units (33 vs. 34). There were no differences in adverse events between treatment arms (0.2% with CPR only vs. 0.3% with CPR+AED) and there were no inappropriate shocks delivered by the lay-trained personnel. There were fewer survivors in the CPR-only group versus the CPR+AED group (15 with CPR only vs. 29 with CPR+AED, p=0.042), with the difference driven by survivors in the public units (14 with CPR only vs. 28 with CPR+AED) rather than the residential units (1 each).

Trial Status: Completed

Review written by Samir Saba, MD