Last December, Thomas Lynch, director of administrative and fiscal affairs for UAB's Division of Cardiovascular Disease, suddenly fell back in his office chair, suffering from cardiac arrest caused by a potentially lethal arrhythmia. It was a week before his 41st birthday.

Office manager Debra Reid witnessed the arrest and summoned Division Director Robert Bourge, MD, whose office is a few feet from Lynch's. Dr. Bourge arrived in seconds, yelled, "call 911," began CPR, and called for the automatic external defibrillator (AED) located just down the hall.

With the help of division administrative office staff, all of whom are trained in cardiac life support and AED use, Dr. Bourge shocked Lynch's heart, restoring normal rhythm in less than 2 minutes. Almost immediately after the shock, Lynch developed a strong pulse, and by the time paramedics arrived, he was moving and responding appropriately to questions. Lynch underwent radiofrequency ablation, performed by Neal Kay, MD, and a cardiac defibrillator was implanted. After a week of recovery, he returned to work.

"Mr. Lynch had a rare, life-threatening condition — ventricular fibrillation caused by Purkinje cell automaticity — that, in his case, was completely curable. But, without the timely shock from the AED, he would probably not be with us today," Dr. Bourge says.

"I've always been a strong proponent of AEDs, and UAB has been involved in defibrillation research for many years. In fact, the UAB's cardiac rhythm lab, headed by Dr. Raymond Ideker, was instrumental in developing the type of shock — a biphasic algorithm — used to convert Mr. Lynch's heart to its normal rhythm," he continues.

"Because we are within minutes of the ED, I'd never really considered placing an AED in our offices," Dr. Bourge says. "But in 2000, one of my nurses collapsed on the 5th floor of the Zeigler building, and it took almost 9 minutes for the paramedics and our ED staff to arrive, which brought into focus the need for such devices, even in a major medical center."

After that incident, Dr. Bourge contacted Floyd Larkin, president of Stop Heart Attack, a company specializing in cardiac resuscitation technology, and Larkin supplied the Division of Cardiovascular Disease with an AED. At the time of Lynch's cardiac arrest, Dr. Bourge's division was the only UAB academic office with an AED.

"Since then, we've dispersed six more AEDs to Department of Medicine academic offices." Larkin says. "The devices are foolproof — although training improves outcomes, it's not possible to deliver an unneeded shock, and even untrained individuals can save lives.

"We are entering an era of true public access to defibrillation; at the Atlanta airport, for example, nine lives have been saved in the last 18 months. Although several responders were untrained bystanders, they were able to successfully use the AEDs because of the devices' simplicity."

Lynch, who remembers little of his event, says he naturally is more conscious of AEDs than in the past. "I was aware of them before, but now, whenever my wife and I go out, we actively look for them and note their location so we can help someone else, if needed."

Dr. Bourge strongly encourages placement of AEDs in public locations in the community. "Publically placed AEDs have a great probability of saving a life. I'd like to see them installed in every bank branch in Birmingham. Because there are banks on practically every corner, the public would know that wherever there's a bank, there's an AED."