There’s a paradox to sudden cardiac arrest that has frustrated the lifesaving community for a long time.
We know what stops it. We know how to save its victims. And yet survival is poor – less than 12% nationally – and has been for years.
The disconnect is one of speed. The most important therapies required when someone’s in out-of-hospital cardiac arrest (OHCA), cardiopulmonary resuscitation and defibrillation, must be delivered quickly. Survival rates fall by 7%–10% a minute without intervention, meaning victims who have to wait for 9-1-1 calls and EMS responses face grim odds even if help is fast.
CPR can provide some blood to the brain in the meantime, but defibrillation is typically required to end an arrest and restore the heart to a perfusing rhythm. Delay it too long, and victims face neurological devastation even if they survive.
Advocates have worked valiantly for years to expedite the process. They rightly tout bystander CPR and AEDs in public places as pieces of the solution. Yet apart from a small number of standout communities, the survival needle hasn’t much budged.
“We have more AEDs out there than ever, but they’re not actually getting to the patients who need them, when and where they need them, any more often,” said Sameer Jafri, CEO of Avive Solutions and an advocate since childhood for cardiac arrest prevention and care. “If all we’re doing is putting more AEDs out there, we’re solving for the wrong problem. We need to solve for the delivery and access piece, which is the core gap to improving outcomes.”
Avive has a unique idea for increasing access to defibrillation and reducing the critical time to intervention that may do just that.
AN IDEA IS BORN
Jafri was exposed early to cardiac arrest and its impact on lives. As a high schooler in San Diego, he became active with the Eric Paredes Save a Life Foundation, which combats the condition among youth. He accompanied his mother, a physician, as she volunteered at screenings for the organization to identify teens at risk.
In college at UCLA Jafri and two friends founded the Saving Hearts Foundation, which embraced a similar mission. It provided ECG and echocardiogram screenings for young adults to identify conditions or warning signs that could precede cardiac arrest. Still active today, it has now screened more than 5,000 people across the greater Los Angeles area.
“Playing some small part in helping potentially save someone’s life is maybe the best feeling in the world,” Jafri said. “I wouldn’t trade it for anything.”
Meanwhile, 3,000 miles from Westwood, a pair of young engineering students at the Massachusetts Institute of Technology (MIT) were working on a novel project. Rory Beyer and Moseley Andrews were outdoors enthusiasts – Beyer had been a backpacking guide in Yosemite, Andrews an avid hiker and skier – who had come to recognize a need for easy, portable assistance if an arrest were to happen in the backcountry. The solution they envisioned was a cell phone-powered AED.
They set out to build the device as part of a senior-year design project. It was an ambitious idea: Beyer and Andrews had only weeks to develop a product and business plan and complete construction before demonstrating their idea to fellow students, faculty and a national audience. When they did, it was honored as the year’s most innovative project.
A chance meeting in 2017 brought Jafri, Andrews and Beyer together. Jafri was at Parent Heart Watch’s Heart to Heart Conference on behalf of the Saving Hearts Foundation, Andrews and Beyer to present the first version of their AED. Mutual acquaintances introduced them. As three of the few 20-somethings in attendance, they hit it off. Ultimately, they decided to join forces in Avive.
“I loved what they’d built and thought it could have a real impact on communities and families,” said Jafri. “We all felt tremendously pulled toward the mission and opportunity to make a difference.”
Jafri now serves as the company’s chief executive officer, Beyer as its president and chief operating officer, and Andrews as its chief technology officer. And with FDA approval for its flagship portable AED granted in October, Avive is now ready to start putting its idea to the test.
MORE THAN AN AED
The Avive Connect AED isn’t cell phone-powered, but it did emerge from the cofounders’ initial concept. And at just 2.1 pounds, it’s the smallest, lightest FDA-approved AED on the market.
That unique portability is one key to Avive’s approach. The other is unprecedented connectivity, with the device having cellular, Bluetooth, Wi-Fi and GPS – functionality the company calls REALConnect.
In participating communities, Avive’s product will be the first device to integrate with 9-1-1, enabling bidirectional data-sharing with telecommunicators.
It works like this: When a cardiac arrest call comes in, that information and location are automatically forwarded to every Avive Connect AED near the scene. That turns bystanders into potential rescuers: Owners or nearby bystanders in participating communities can grab their audibly alerting device, which displays a map to navigate the rescuer to the location of the person in cardiac arrest. The goal is to support EMS and first responders by getting defibrillation to the patient before they arrive on scene.
Data from the device also goes the other way during an emergency, giving 9-1-1 telecommunications key information such as the AED’s location as it’s en route to the victim, the step the user is on while using the AED, and the number of shocks given. EMS and health care providers are quickly provided access to a postincident summary and detailed report.
“What our original concept from MIT allowed us to do was really hone in on the things we thought were important,” said Beyer. “The first was portability. Moseley and I realized a portable AED could be really valuable, but you can’t be carrying a four-, five-, six-pound AED around for long distances.
“Then we wanted it to be approachable, to look and feel like what we use every day. We wanted to make it more accessible, and most importantly, we wanted to make it more connected to enable these new concepts we’re bringing to the table.”
REALConnect also allows streamlining of the device maintenance process – another longstanding obstacle to broader AED use. Avive Connect AED owners have access to wireless daily monitoring and automated notifications of maintenance needs, as well as remote software updates to AEDs in the field. For owners of a single AED or large fleets, this provides constant visibility to simplify upkeep and help ensure readiness.
The Avive Connect also has the AED industry’s only embedded rechargeable battery, lowering the device’s total cost of ownership. The AED’s battery can last more than eight months between charges and is designed to never need to be replaced.
Additional features include child mode, English/Spanish operation, and being the first device to visually depict a female anatomy to encourage bystander action on victims of all genders.
POWER TO THE PEOPLE
The goal of this all is to bring defibrillation technology to the masses in a way that can finally move that proverbial needle. That means growing the culture of bystander aid and arming willing rescuers with the tools to make a difference. Avive’s 4-Minute City Program is an ambitious effort to organize AED networks around where cardiac arrests are known to happen, but that alone can’t reach everyone – individual owners must be an integral part of any solution too.
To that end, the company has provided a simple, portable, affordable advance that’s now ready for the front lines.
“Now we can start getting units deployed in communities and in the hands of customers – that’s really the focus for the entire team,” said Jafri. “There’s a lot of excitement. Our North Star right now is first product shipment, and then shortly thereafter it’ll become our first life saved. And when that happens it’ll be the best gift for all of us in 2023.”
For more on Avive and its founders, see the company’s “More Than an AED” video.
For more information, visit Avive.