The year 2023 marked a turning point for automated external defibrillators (AEDs) in India. After years of advocacy, installations of these life-saving devices began to take off. However, experts warn that despite this progress, less than 1% of people are using AEDs during cardiac arrest.
AEDs Gaining Traction
The Indian AED market saw a significant increase in 2023, with sales jumping to â¹36 crore (approximately £3.5 million) from â¹28 crore (approximately £2.7 million) in 2022. This growth reflects a 29% increase in value, with 6,000 units sold compared to 3,850 units in the previous year.
This surge is driven by growing awareness and supportive policies. Airports, community centres, schools, government buildings, and other public spaces are now actively promoting the installation of AEDs. Globally, the market is valued at USD 1.8 billion (approximately £1.4 billion) and is projected to grow at an 8.6% CAGR.
Government and Industry Support
Governments and healthcare organisations are playing a crucial role in driving this growth. Italy has allocated â¬10 million (approximately £8.8 million) for implementing public access AEDs over the next five years. In Australia, the SA Ambulance Service recommends using a defibrillator as early as possible to increase survival chances.
Meanwhile, companies like Schiller are introducing new AED models, such as the FRED easy G2, designed for both basic and advanced life support. These devices are compact, lightweight, and user-friendly, making them ideal for public access.
The Disconnect: Availability vs. Usage
Despite the increasing availability of AEDs, research indicates a significant disconnect between the number of devices and their actual use.
A study presented at the American College of Cardiology's Annual Scientific Session in Chicago found that AEDs were used in only 13 out of nearly 1,800 cases of out-of-hospital cardiac arrest, even when devices were nearby. Similarly, research at the British Cardiovascular Society Conference in Manchester revealed that defibrillators are used in only one out of ten cardiac arrests where they are available.
A Critical Need for Awareness and Training
The stark reality is that while survival rates from sudden cardiac arrest have improved significantly in the West (by 60-70%), they remain at a dismal 1% in India.
Dr Kumar Narayanan, Senior Consultant Cardiologist and Deputy Chair of The Lancet SCD Commission, highlights the need for increased awareness and training. He stresses that India lacks the infrastructure and policies to widely disseminate CPR and AED training to the public.
Dr Dnyaneshwar Shelke, Chief Operating Officer of BVG- Maharashtra Emergency Medical Services, emphasizes the importance of widespread AED use, stating that immediate CPR and AED use can double or triple the chances of survival.
Beyond AEDs: Exploring the Defibrillator Market
The broader Indian defibrillator market is estimated at â¹290 crore (approximately £28 million) in 2023. The market is divided into monophasic, biphasic, and AED segments.
While monophasic defibrillators continue to hold a significant market share, biphasic devices offer a higher success rate with lower energy delivery. Globally, the defibrillator market is expected to reach USD 20.1 billion (approximately £15.6 billion) by 2031.
Key Players in the Indian Market
Leading players in the Indian defibrillator market include:
Monophasic: BPL, Schiller, UNI-EM, and regional brands
Biphasic: Schiller, BPL, Allied, Trivitron, Mindray, Nihon Kohden, Philips, Zoll, and Mediana
AED: Philips, Radian Qbio, Beijing M&B, Zoll, Nihon Kohden, Mindray, Schiller, Mediana, and Cardiac Science
Innovation Driving the Future
The defibrillator market is witnessing several innovative developments, including:
Pairing defibrillators with automated CPR devices: Devices like Michigan Instruments' Life-Stat offer uninterrupted chest compressions during defibrillation, improving resuscitation efforts.
Double sequential external defibrillation (DSED): This new procedure uses two defibrillators to deliver rapid sequential shocks, potentially increasing survival rates for patients unresponsive to standard defibrillation.
Subcutaneous implantable cardioverter defibrillator (S-ICD): This alternative to traditional ICDs offers easier implantation and reduces the risk of complications associated with venous access.
Conclusion
The increasing availability of defibrillators in India represents a significant step towards improving cardiac care. However, the challenge remains in bridging the gap between availability and usage. By prioritizing public awareness, promoting widespread training, and fostering supportive policies, we can harness the potential of these life-saving devices to improve outcomes and save lives. The future of defibrillator technology holds immense promise, with innovations continuing to improve efficacy and accessibility, ultimately transforming the landscape of cardiac emergency response.