This study has two purposes: 1) to determine whether spouses of patients discharged alive following an episode of ventricular fibrillation (VF) can be trained in the use of a home defibrillator, and whether the machine can be used successfully in treating episodes of cardiac arrest; 2) to determine the technological impact of home defibrillation, to determine the costs, as well as the physical and psychological benefits and risks. The rationale for this study is the fact that two-thirds of all out-of-hospital cardiac arrests due to heart disease have VF as the dysrhythmia causing collapse. The sooner defibrillatory shocks are provided the more likely the patient will survive. Rapid defibrillation provided directly at the scene of collapse by a trained spouse offers the potential to save many more lives than can be saved with existing emergency services. During phase I of the study (six months) an automatic defibrillator will be field-tested by trained paramedics to determine reliability. Results from Phase I will be reviewed by a Medical Advisory Panel before preceding with Phase II. Phase II (two years) will identify appropriate patients, obtain their consent to participate, and randomly assign them to treatment groups where one group receives cardiopulmonary resuscitation training (CPR), and the other group receives both CPR training and training in the use of an automatic defibrillator. Psychological and behavioral considerations will be tested and assessed. Technological impact will be determined using data obtained from the study.
