Use of an automated external defibrillator-pacemaker by ambulance staff.

A new portable external device detects ventricular fibrillation and profound bradycardia or asystole by analysis of wave forms; it automatically delivers a defibrillating shock or repetitive pacing stimuli. Ambulance crews used the device on 27 cardiac-arrest patients. The initial group (16) was restricted to patients prejudged as probably beyond successful resuscitation, and none survived. The subsequent group (11) was not restricted. 5 were discharged alive from the hospital. The device is simple to use, and its application by modestly trained technicians and lay people may be feasible. Widespread use of the device as an adjunct to conventional cardiopulmonary resuscitation could reduce mortality from out-of-hospital cardiac arrest. The capability for external cardiac pacing enhances the efficacy of treatment.