Airlines and gambling casinos were among the first industries to realize the value of automatic external defibrillators (AEDs), and sports – whether the spectator variety or actively pursued – may be offering the next large wave of installations. The particular beneficiary of this trend is Philips, which has won two high-profile contracts for installation of its Heartstream (Seattle, Washington) AED systems, added to the Philips product line through purchase of the Healthcare Solutions Group (Andover, Massachusetts) of Agilent Technologies (Palo Alto, California).

Last month, the San Francisco Giants reported that they will install 25 Heartstream FR2 AEDs throughout Pacific Bell Park, saying it is the first major league baseball club to launch a public access AED program. The club will place 19 of the units in wall-mounted cabinets in various spots throughout the park, and it will put six devices in team locker rooms and executive offices.

David Freeman, worldwide marketing manager for Philips Medical/Heartstream, said the importance of the initiative is not the installation but also the development of a systematic program for use of the devices. Stadium signage and maps are being updated, with brochures marked with icons indicating the location of the AEDs, and more than 100 park employees will be trained to use the devices. The club also is working to sponsor a variety of community programs to train members of the public in AED use. The entire effort will be promoted on the park's big stadium screen with a video designed to alert fans to the presence of the AEDs and how to use them.

Giants management said that the program is based on initiatives developed at Chicago's O'Hare and Midway airports, which have reported a survival rate of 68% in sudden cardiac attacks since it installed the devices, a dramatic improvement over the typical survival rate of just 5% estimated by the American Heart Association (Dallas, Texas).

In late October, Philips also signed an agreement with the International Health, Racquet and Sportsclub Association (IHRSA; Boston, Massachusetts) to supply the FR2 AED systems to the association's 3,600 member clubs in the U.S., those clubs representing a membership of about 9 million people. "Our overall motivation is borne from our recognition that the technology in AEDs, with some basic training, can be deployed in a setting like a club," said Bill Howland, director of public relations and research at IHRSA. "For cardiac arrest, an AED is the only answer." He added, "We have 20 years of experience talking to our members. Through a monthly trade magazine, online or at our annual trade show, we have multiple opportunities to give small club operators up to the CEO of a large chain the information on purchasing AEDs." About a third of the member clubs are expected to install the devices annually over the next three years as part of IHRSA's Healthy Heart AED program, an association spokesman said, with the program also offering training in AED use.

"This is an enormously powerful movement," Freeman told Cardiovascular Device Update. "This notion of getting AEDs out in the public ... It's catching on, word is getting out, not just on the clinical level but also to the public."

In other examples of AED proliferation, Cardiac Science (Irvine, California) last month also scored two contracts for its AEDs, added to its product line through the recently completed acquisition of Survivalink (Minneapolis, Minnesota). Japan Airlines (JAL; Tokyo) will purchase 130 of the Survivalink AEDs for installation and use in its fleet, making it the first Japanese airline to use AEDs and the first non-medical organization in Japan to purchase this equipment. Additionally, Cardiac Science reported the purchase of 139 units for installation in U.S. government sites around the country, with deployment in the public areas of those facilities.

Raymond Cohen, president and CEO of Cardiac Science, said that when AEDs become as commonplace as fire extinguishers, "the halls of government, corporate and private institutions will, in turn, be safer for workers and visitors."

Study sees decline in heart disease

American adults are leading healthier lives and thus are significantly reducing their risk of heart disease mortality, according to a new University of California, San Francisco (UCSF; San Francisco, California) study published in the Oct. 1 issue of The Journal of the American College of Cardiology. "Reductions in heart disease risk factors, such as smoking, blood pressure and cholesterol levels, represent a major public triumph," said Lee Goldman, MD, lead author of the study and chair of the UCSF Department of Medicine. "We found that substantial reductions in heart disease risk factors are well worth the cost, in part because of reductions achieved by the American public's positive changes in lifestyle and habits." That conclusion comes from an analysis of data from the Coronary Heart Disease (CHD) Policy Model, a validated computer simulation model of heart disease among the Americans between the ages of 35 and 84.

The UCSF researchers found that reductions in heart disease risk factors dramatically reduced the number of heart disease related deaths among Americans by 430,000 a year – and overall deaths by 740,000. Goldman added that most of the decline in heart disease-related deaths were the result of reductions in blood pressure and cholesterol levels, while reductions in non-heart disease related mortality were attributed to a fall in smoking rates.

Using this information, they estimated the blood pressure and cholesterol levels and the smoking characteristics of the U.S. adult population during the period of 1981 to 1990 and then projected those estimates to 2015. The researchers then estimated the costs of the population-wide medical efforts initiated to reduce heart disease risk factors (i.e., blood pressure and cholesterol screening and treatments, anti-smoking campaigns, smoking cessation programs) and their impact on heart disease incidence, prevalence and mortality.

The researchers reported that from 1981 to 1990, much of the reduction in cholesterol levels was due to population-wide dietary changes, which is cost-effective and yields modest yet significant results in millions of people. For the reduction of high blood pressure, the widespread use of medications, albeit rather expensive, were still found to be cost-effective. Smoking cessation programs were reported to have substantial benefits over the short and long term and be cost-effective. In addition, many smokers tend to quit on their own with very limited medical inputs.

Such efforts cost an estimated $44,000 per person during the 10-year period between 1981-1990. If reductions in risk factors are maintained from 1991-2015, the UCSF researchers project that the efforts would cost only about $3,200 per person per year and prevent 3.6 million heart disease-related deaths and 1.2 million non-heart disease related deaths over the 35-year period.