TY - JOUR
T1 - Rationale and design of the Home Automatic External Defibrillator Trial (HAT)
AU - Bardy, Gust H.
AU - Lee, Kerry L.
AU - Mark, Daniel B.
AU - Poole, Jeanne E.
AU - Toff, William D.
AU - Tonkin, Andrew M.
AU - Smith, Warren
AU - Dorian, Paul
AU - Yallop, Julie J.
AU - Packer, Douglas L.
AU - White, Roger D.
AU - Longstreth, Will
AU - Anderson, Jill
AU - Johnson, George
AU - Bischoff, Eric
AU - Munkers, Crystal D.
AU - Brown, Amanda
AU - McNulty, Steven
AU - Ray, Linda Davidson
AU - Clapp-Channing, Nancy E.
AU - Rosenberg, Yves
AU - Salive, Marcel
AU - Schron, Eleanor B.
PY - 2008/3/1
Y1 - 2008/3/1
N2 - Most cardiac arrests occur in the home, where emergency medical services (EMS) systems are challenged to provide timely care. Because a large proportion of sudden cardiac arrests (SCAs) are due to ventricular tachycardia or ventricular fibrillation, home use of an automated external defibrillator (AED) might offer an opportunity to decrease mortality in those at risk. Predicting who will have a cardiac arrest in the general population is difficult. Individuals at high risk are usually easily identified and may become candidates for implantable cardioverter defibrillators. It is within the population at lower risk where home AEDs may be most useful. The purpose of the Home Automatic External Defibrillator Trial (HAT) is to test whether providing home access to an AED can improve survival in patients at modest risk of SCA, such as those surviving an anterior myocardial infarction but in whom implantable cardioverter defibrillator therapy is not deemed necessary. Between January 23, 2003, and October 20, 2005, 7001 patients were enrolled, with completion of follow-up scheduled for September 30, 2007. Randomization was conducted in a 1:1 fashion between control therapy, comprising the standard lay response to SCA (calling the EMS and performing cardiopulmonary resuscitation), and the use of an AED first, followed by calling the EMS and performing cardiopulmonary resuscitation. The primary end point is all-cause mortality. Secondary outcomes include survival from SCA (witnessed and unwitnessed, in home and out of home), incremental cost-effectiveness, and quality of life measures for both the patient and the spouse/companion. The results of the trial should be available in mid 2008.
AB - Most cardiac arrests occur in the home, where emergency medical services (EMS) systems are challenged to provide timely care. Because a large proportion of sudden cardiac arrests (SCAs) are due to ventricular tachycardia or ventricular fibrillation, home use of an automated external defibrillator (AED) might offer an opportunity to decrease mortality in those at risk. Predicting who will have a cardiac arrest in the general population is difficult. Individuals at high risk are usually easily identified and may become candidates for implantable cardioverter defibrillators. It is within the population at lower risk where home AEDs may be most useful. The purpose of the Home Automatic External Defibrillator Trial (HAT) is to test whether providing home access to an AED can improve survival in patients at modest risk of SCA, such as those surviving an anterior myocardial infarction but in whom implantable cardioverter defibrillator therapy is not deemed necessary. Between January 23, 2003, and October 20, 2005, 7001 patients were enrolled, with completion of follow-up scheduled for September 30, 2007. Randomization was conducted in a 1:1 fashion between control therapy, comprising the standard lay response to SCA (calling the EMS and performing cardiopulmonary resuscitation), and the use of an AED first, followed by calling the EMS and performing cardiopulmonary resuscitation. The primary end point is all-cause mortality. Secondary outcomes include survival from SCA (witnessed and unwitnessed, in home and out of home), incremental cost-effectiveness, and quality of life measures for both the patient and the spouse/companion. The results of the trial should be available in mid 2008.
UR - http://www.scopus.com/inward/record.url?scp=39249085617&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=39249085617&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2007.12.008
DO - 10.1016/j.ahj.2007.12.008
M3 - Article
C2 - 18294476
AN - SCOPUS:39249085617
VL - 155
SP - 445
EP - 454
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -