Home defibrillation: A new solution shifts the paradigm

The small, lightweight Avive Connect AED is part of a new approach to improving cardiac arrest survival

In December 2019, many of the resuscitation world’s top experts and advocates gathered in Seattle for the annual Cardiac Arrest Survival Summit. Julie Buckingham, a career 911 professional and faculty member at the city’s famed Resuscitation Academy, was speaking with a prominent emergency physician when they were approached by a young man with a small AED.

Rory Beyer was the cofounder of a new company called Avive Solutions, and his AED was a prototype of a revolutionarily small, light and portable device that would become the company’s Avive Connect AED. Avive planned to bring its idea to market with a unique new approach that could, Beyer and his colleagues believed, finally impact the persistently dismal rate of cardiac arrest survival in the U.S.

“I remember when he walked away,” recalled Buckingham, “[the doctor] and I were like, ‘Can you imagine having an AED small enough to carry around with you like that? That would be amazing! I’d put one in my car and always have it!’”

Less than four years later, the Avive Connect AED is approved by the FDA and ready for buyers. And Buckingham was enthused enough about the idea to sign on as Avive’s community programs coordinator.

MINUTES MATTER

While CPR is an essential bridge to provide some oxygen to the brain, ending the disruption of an arresting heart typically requires defibrillation – and the quicker, the better. Without intervention, survival from even the most treatable kinds of cardiac arrests falls by 7%–10% a minute. Faster resolution also minimizes the brain’s time without oxygen and aids survivors’ neurological outcomes.

“Minutes matter,” said Buckingham, who has also worked in EMS dispatch and quality improvement. “Even shaving two to three minutes off the delivery of definitive care for cardiac arrest, which is what an AED is, can be the difference between a good outcome and a less-than-optimal outcome. I look forward to the day where everyone has an AED in their home, right next to their fire extinguisher, because they recognize its value as safety equipment.”

Empowering such would-be rescuers to intervene in arrests and help sustain patients until EMS arrives would represent an important paradigm shift. While nearly 90% of cardiac arrests occur in the home, home defibrillation has not been promoted as a measure against them. There have been a few reasons for that.

One is the cost of AEDs. Another is their lack of portability. A third is the worry of ensuring they’re maintained and ready when they’re called upon. The Avive Connect AED addresses each of these concerns.

At just 2.1 pounds, the Avive Connect is the smallest, lightest AED available today. That makes it highly portable and suited not only for use in the home but also for carrying in vehicles and even on a potential user’s person – a feature that initially drove its outdoors-enthusiast inventors.

In addition, Avive’s REALConnect functionality – which combines cellular, Bluetooth, Wi-Fi and GPS capabilities – helps enable a simplified, streamlined maintenance process. Device health can be wirelessly monitored each day and owners automatically notified of anything requiring attention. When needed, software can be updated remotely. This helps owners rest easy knowing their devices will be up to date and operational when a cardiac arrest occurs.

The Avive Connect AED also has the industry’s only embedded rechargeable battery, which can last more than eight months between charges and should never need to be replaced. And it’s been priced accessibly for home users who wish to expand their rescue capacity.

Other attributes of the Avive Connect AED include an easy-to-operate touchscreen, child mode for pediatric victims, operation in both English and Spanish, universal electrode pads and accurate depictions of female anatomy to guide use.

WHAT’S MISSING IN THE CHAIN OF SURVIVAL?

While home defibrillation is a relatively new concept, some of America’s top cardiac doctors have given it their blessing.

“I think it’s a terrific idea,” prominent emergency physician Benjamin Abella, M.D., FACEP, FAHA, told the “New York Times” in April, comparing AEDs to fire extinguishers and noting he recently acquired his own. While promoting the lifesaving devices in public spaces, the American Heart Association also supports anyone who wants to obtain an AED, with vice president Comilla Sasson, M.D., Ph.D., suggesting it could help reduce anxiety around their use.

“In the chain of survival, the AED is one thing that’s really still missing,” said Buckingham. “When you look at the statistics, the incidence of defibrillation before first responders arrive in a residential setting – or in any setting, really – is almost nonexistent. We think this device can break down some of the barriers that may keep people who are interested in going beyond just getting a CPR card from taking that next step and being ready to defibrillate.”

In the early minutes of a cardiac arrest, that’s the most important thing any bystander can do – even CPR is only a temporizing measure. EMS will bring sophisticated equipment, drugs and expertise for more-definitive care, but it’s up to bystanders to sustain such patients until then.

The other big difference the Avive Connect AED brings to the table – and where Avive’s approach becomes truly unique in the rescue world – is its unprecedented connectivity. In participating communities, Avive Connect AEDs will integrate directly with 911.

That means, when a cardiac arrest call is received in those communities, its location and other information can be automatically forwarded to every Avive Connect unit within a radius around it. Those units will sound audible notifications and display maps that lead their owners or other bystanders, along with the AED, to the patient in distress. Once there, the AED will walk them through applying pads, evaluating the heart’s rhythm and delivering a shock if needed. This should provide those patients faster defibrillation than waiting for an ambulance crew.

The Avive Connect also shares information back to 911 telecommunicators, telling them its location throughout the response, which step of the rescue the user is on and the number of shocks delivered. It also produces quick postincident summaries and detailed reports for further care and quality review.

These attributes, along with its low cost and easy maintenance, also make it a strong choice for EMS systems that need to equip entire fleets.