McDaniel C M, Berry V A, Haines D E, DiMarco J P
Department of Internal Medicine, University of Virginia, Charlottesville 22908.
Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 2):2029-34. doi: 10.1111/j.1540-8159.1988.tb06345.x.
Automatic external defibrillation (AED) offers the potential for minimally trained individuals to convert life-threatening ventricular arrhythmias prior to arrival of emergency rescue personnel but optimum usage of AED remains undefined. To test the practical aspects of home AED in high risk patients after myocardial infarction, we identified 40 consecutive high risk post-MI patients, who satisfied inclusion and exclusion criteria. Fifteen (38%) patients were eliminated at their physician's request and nine others refused to participate. Twenty-six family members of the remaining 16 patients were trained in AED with follow-up testing at 3 months. Level of skill, especially in CPR performance, decline to unsatisfactory levels in 35% of trainees, including all over age 55. Trainees felt more confident due to availability of AED and 90% felt no strain in intrapersonal relationships. Psychological testing revealed a decrease in patient and trainee depression scores and no change in anxiety or obsessiveness during the study. These observations suggest the following: (1) better awareness of benefits of AED by physicians and lay persons is necessary, (2) retraining at less than 3 month intervals will be required for many spouse trainees and (3) there are no common adverse psychologic sequelae to training in AED.
自动体外除颤器（AED）使未经充分培训的人员有可能在急救人员到达之前将危及生命的室性心律失常转复，但AED的最佳使用方法仍不明确。为了测试心肌梗死后高危患者家庭使用AED的实际情况，我们连续纳入了40例符合纳入和排除标准的心肌梗死后高危患者。15例（38%）患者应医生要求退出，另有9例拒绝参与。其余16例患者的26名家庭成员接受了AED培训，并在3个月时进行了随访测试。技能水平，尤其是心肺复苏操作水平，在35%的受训者中下降到了不满意的程度，其中包括所有55岁以上的受训者。由于有AED，受训者感到更有信心，90%的人感觉人际关系没有压力。心理测试显示，在研究期间，患者和受训者的抑郁评分降低，焦虑或强迫观念没有变化。这些观察结果表明：（1）医生和普通民众需要更好地认识AED的益处；（2）许多配偶受训者需要每隔不到3个月重新培训一次；（3）培训AED没有常见的不良心理后遗症。
