Defibrillator access pays dividends.

Making electronic heart stimulators available in public facilities and training lay people there how to operate them can boost the chances of survival for people who suffer cardiac arrest--a loss of pulse-in such places, according to new findings.

Researchers went to 993 shopping malls, apartment buildings, office buildings, sports facilities, and other public places in the United States and Canada and trained nearly 20,000 people in these facilities how to spot cardiac arrests and how to administer cardiopulmonary resuscitation (CPR). At half the sites, researchers also taught people how to operate a heart-shocking defibrillator and stored one on-site. All participants in both groups were instructed to call 911 first in the event of a cardiac arrest.

Over nearly 22 months, the trainees at sites equipped with defibrillators resuscitated 29 people who had suffered cardiac arrest compared with only 15 CPR--only resuscitations by their counterparts in the places without the devices, says Joseph P. Ornato of Virginia Commonwealth University in Richmond. There are roughly 460,000 out-of-hospital deaths attributed to cardiac arrest each year in the United States. N.S.