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After defibrillation last updated 10/29/02

Since the probability of re-occurrence of a Sudden Cardiac Arrest is about 50% within 18 months something should be done.  The following are some of the options to reduce probability of death with re-occurrence:.

1) Implant a Cardioverter-defibrillator.  Implantation surgery survival rate is 96% to 99%. Recent designs weigh 150 grams and occupy 70 cubic centimeters and are implanted in the pectoral region. The total cost is $40,000 to $60,000. The ICD shock is very intense: 7.9 on a pain scale of 1 to 10.  Life expectancy is extended by 6.6 years average - some say that it just eliminates death due to heart attack and may extend the life by decades.. 

2) Drug Therapy.  Taken from the above reference. Cost $42,400 to $60,00 - average $51,000.  Life expectance with amiodarone is 5 years.
http://www.acutecare.com/amio.htm  several links
http://www.heartinfo.org/reutersnews/t0916-4f.htm  New England Jr. of Med Sept 1999
              Use of drug if AED did not work  44% survival vs. 34% placebo 

The AVID trial with 1016 patients was comparing ICD and Drug Therapy was stopped when it was found that there was a 'significant reduction in deaths by the ICD portion of the study" http://www.medtronic.com/tachy/patient/beatfast/picddrug.html

3) Catheter Ablation can be used to prevent re-occurrence of ventricular tachycardia (V-tach), which is one of the two causes of Sudden Cardiac Arrest. This can be done with microwave frequencies which are applied without major surgery.  
http://www.americanheart.org/Scientific/statements/1995/159501.html Unknown cost: 
http://www.cardima.com/vt_articles.html
http://www.bme.jhu.edu/courses/580.471/termpapers/ewong.html  RF (not microwave) in 1995
http://www.futuraco.com/farre.htm  400 page book review of 10 years of practice, cost $145
http://www.cardima.com/vt_jce.html   clinical paper 1997

4) Skycar quickly deliver automatic external defibrillator again.  Note that at best the probability of surviving two Sudden Cardiac Arrests with Skyaid and Skyaid Watch is 70%x70% = 50%.  This is far better than the typical 911 situation: 5% x 5% = 0.25%