20-Year Audit of Community Issued Automated External Defibrillators, Auckland City Hospital 2002–2022

Abstract

Early community defibrillation has been shown to improve survival in patients with cardiac arrest. Providing home automated external defibrillators (AEDs) to patients who do not meet guidelines for an implantable cardioverter defibrillator (ICD) implant, have significant contraindications for an ICD implant, or do not wish to have an ICD implanted is a service delivered by some hospitals. This was a retrospective audit of patients issued an AED by Auckland City Hospital 2002–2022. A telephonic survey of active patients was undertaken. Over the 20-year period, 34 patients were issued AEDs. Mean age was 18.5 years with 58.5% aged ≤15 years at date of issue; 58.8% were NZ European and 14.7% Māori. The predominant cardiac diagnosis was Long QT syndrome (41.2%) followed by hypertrophic cardiomyopathy/hypertrophic obstructive cardiomyopathy (23.5%). Twenty-one patients still have AEDs. Of four patients who had multiple prior cardiac implantable electronic device (CIED) implants and lead extractions, one proceeded to a heart transplant, and one died. Six patients proceeded to CIED implants: three ICDs and three implantable loop recorders (ILRs). No surveyed patients required AED therapy. All surveyed patients/caregivers reported that home AED gives them peace of mind. Issuing of home AEDs is not standard clinical practice, but for specific patients who do not meet guidelines, are unwilling to have or have contraindications to an ICD, it provides peace of mind. No surveyed patients required AED therapy.