The world health organisation estimates that 18.1 million deaths globally will be attributed to cardiovascular diseases in 2010. Over five million Europeans are being affected by heart failures and 600,000 new cases are being diagnosed every year. The European cardiovascular disease statistics informs that each year 1.9million deaths are related to cardiac diseases, this accounts for nearly half (46%) of the deaths in Europe.
Sudden cardiac arrests, as the name suggests happens suddenly when the heart stops functioning and little or no blood is pumped into the body. However, this indication should not be confused with heart failure or myocardial infarction where the blood vessels are blocked affecting blood supply to a portion of the heart muscle. Heart attacks refer to loss of heart tissue resulting from inadequate blood supply. The cardiac victim may experience a sudden cardiac arrest but heart attacks and sudden cardiac arrests are not synonymous. However, all cardiac diseases can lead to sudden cardiac arrests and sudden cardiac deaths. Sudden cardiac arrests are caused by the disruption of electrical pulses which lead to irregular heart rhythm and stop the heart beat. The heart beat can become rapid (Ventricular Tachycardia) or chaotic (Ventricular Fibrillation), the victim could also experience both. One of the main underlying reason leading to deaths in adults by sudden cardiac arrests are coronary heart diseases, where deposits of fat clog two or more coronary arteries restricting blood flow. Other heart abnormalities causing sudden cardiac arrest in young adults are intense physical or athletic activity where adrenaline release can affect cardiac rhythm and the use of elicit drugs. However, it should also be noted that various heart medication could affect heart rhythm.
Victims of sudden cardiac arrest should be offered immediate defibrillation to prevent death, brain damage and other complications. During cardiac arrests the brain and other vital organs become quickly deprived of life sustaining oxygen and nutrients. Lack of oxygen for a few minutes could lead to sudden death. For every minute that passes without defibrillation, chances of survival decrease 7-10%. The critical window of opportunity for successful defibrillation is 10 minutes. Hence access to victims of sudden cardiac arrests is vital to ensure chances of survival.
The Task Force of the European Society of Cardiology and European Resuscitation Council has found that the majority of deaths from coronary diseases in out of hospital environments, do not survive long enough to receive medical treatment and that communication between modalities are slow affecting critical treatment of patients.
Statistics show that 80% of sudden cardiac arrests take place in homes and 15% in public access areas. The need for greater access to defibrillation is becoming more widely acceptable and manufacturers of external cardiovascular defibrillators are leveraging this opportunity and developing user friendly and ergonomically convenient automatic external defibrillators to cater to this market.
Currently, legislation around Europe with regards to resuscitation is heterogeneous; however most of the countries in Europe do not have laws restricting layperson use building the grounds for greater uptake of automatic external defibrillators in public access areas.
Many countries in Europe are considering regulatory laws with regards to use of AEDs. The French and Spanish government are currently reviewing legislation in place and it is rumoured that more favourable laws requiring deployment of AEDs in public access areas will take place. This help boost up sales for AEDs at an accelerated pace.
Some of the products available in the market for layperson use include Philips HeartStart Home Defibrillator, Samaritan® AED, Zoll AED Plus, LIFEPAK® CR Plus Defibrillator and FRED® easyport. These are specifically engineered to facilitate layperson use, by providing. The European Society of Cardiology and European Resuscitation Council suggest that automatic external defibrillators could play a critical role in the implementation of early defibrillation.
Factors driving sales of AEDs are the increasing awareness of the need for early defibrillation and acceptance of the use of automatic external defibrillators by the laypersons. The increase in awareness is being driven by enthusiast healthcare providers and the increasing awareness of politicians towards sudden cardiac arrests. Due to the heterogeneous legislation surrounding the use of AEDs the European Society of Cardiology and European Resuscitation Council is not able to draw legislation with regards to AED usage but reached a consensus which states that: Effective AED programmes within Emergency Medical Services should be implemented, and that an AED and trained personnel should be placed in all vehicles carrying patients at risk of cardiac arrests.
Most sudden cardiac arrests take place in homes, but home programmes are still in preliminary phases, however the ESC and ERC recommend that families with genetic predisposition to sudden cardiac deaths should be the primary target for the pilot program.
Frost & Sullivan examining the above factors contributing to the uptake of AED has found that sales of AEDs will continue to grow by 20% annually, taking in consideration that favourable laws with regards to deployment of AEDs in Europe will take place.
The market for external cardiovascular defibrillators in Europe 2004 is estimated to be worth $226.7 million. The market for external cardiovascular defibrillators in the Europe is becoming highly consolidated, with large market shares being accumulated by three main players in the market. Medtronic holds the leadership position by holding a market share of 36% followed by Philips with 22% of the total market for external cardiovascular defibrillators.
Due to high competition in the market, budgetary restraints and increasing need for more affordable products prices of automatic external defibrillators are expected to decrease by approximately 5%.
In conclusion, defibrillation was historically offered by highly trained medical personnel due to the complexity of the devices. However, continues research and development by manufacturers of external cardiovascular defibrillators has been revolutionalized opening the portal of opportunity to the public domain to perform the ethical duty of helping a fellow human being in need and perform a life saving operation. Factors contributing to sudden cardiac arrests such as the ageing population, and the increasing awareness of the need for early defibrillation will drive sales for AED in Europe. The challenge for external cardiovascular defibrillators market will be to overcome the bureaucratic burden currently in place in most European countries.
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