The prevention of sudden cardiac death: The role of the automated external defibrillator

Sudden death is usually the result of hemodynamically destabilizing ventricular tachycardia or ventricular fibrillation. Because the only definitive treatment for ventricular tachycardia/ventricular fibrillation is a direct current shock, and because that defibrillating shock must be given very quickly to be effective, the American Heart Association's "chain of survival" approach to persons with a cardiac arrest emphasizes early access to care, early cardiopulmonary resuscitation, early cardiac defibrillation and early advanced life support. The link in this chain of survival that has been changing most dramatically over the past decade is that of early defibrillation. The automated external defibrillator enables life-saving defibrillation therapy to be provided to the cardiac arrest victim by nontraditional responders, Such as the general public. The present review evaluates the current role of the automated external defibrillator in the ongoing Struggle to prevent sudden cardiac death.