Should AED Placement Be Expanded to Nontraditional Exercise Facilities?

A new study showing survival following sudden cardiac arrest (SAC) at nontraditional exercise facilities like indoor tennis centers, ice arenas and bowling alleys, is lower than at gyms, health clubs and other formal exercise centers, could have important public health implications for placement of automated external defibrillators (AEDs).

"It's probably reasonable to have [AEDs] in formal exercise facilities... however, with the great majority of cardiac arrests occurring outside of exercise facilities, it's going to be difficult to figure out where to put AEDs in general," said Alfred Bove, MD, MACC.

The study, published in the Journal of the American College of Cardiology, was based on an analysis of 849 nontraumatic SACs occurring in public indoor locations in Seattle and Kings County, WA, from 1996 to 2008. Of the SACs analyzed, 52 were at traditional exercise facilities, 84 were at alternative exercise facilities and 713 were in sites not associated with exercise.

According to the study results, SAC incident rates were higher at indoor tennis facilities (0.092 SAC/yr), indoor ice arenas (0.077 SAC/yr) and bowling alleys (0.037 SAC/yr) than at formal exercise facilities (0.024 SAC/yr). Community centers had a similar incident rate (0.020 SAC/yr) as formal exercise facilities, while some alternative facilities, including roller skating rinks, dance studios, hotel gyms and martial arts schools, had lower SAC rates than formal facilities. Also of note, survival to hospital discharge was greater following SACs at formal exercise facilities (56 percent) than at alternative facilities (45 percent), although the difference was not statistically significant.

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“The findings should encourage broader implementation of and adherence to recommendations and regulations for AED placement and SCA response protocols at traditional exercise facilities,” the study authors note. They also recommend that these standards be extended to alternative fitness facilities, “where SCA site incidence rates are comparable to those at traditional exercise facilities.”

Clinical Topics: Arrhythmias and Clinical EP, Implantable Devices, SCD/Ventricular Arrhythmias

Keywords: Incidence, Defibrillators, Public Health, Fitness Centers, Death, Sudden, Cardiac

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