A Brief History of The Defibrillator. When Was The Defibrillator Invented?

What Is Fibrillation, and How Does an AED Stop It?

Electrical signals to the heart keep it beating at a regular rhythm. If something happens to disrupt the signals, such as a heart attack or illicit drug use, the fibers of the heart muscle can start fibrillating, or quivering. Fibrillation prevents the heart from pumping blood and oxygen effectively to the body’s major organs.

There are two types of fibrillation that can occur:

•  Atrial fibrillation involves at least one of the two small chambers at the top of the heart.
• Ventricular fibrillation involves one of the two larger chambers at the bottom. 

Atrial fibrillation is more common, but ventricular fibrillation is more serious and therefore more likely to require external defibrillation on an emergent basis.

A defibrillator works by delivering an electric shock to the heart. This allows normal conduction of the heart’s electrical impulse to resume by depolarizing the cardiac muscles. 

Atrial fibrillation is usually not a medical emergency and is more often treated with an implantable defibrillator, sometimes called a pacemaker, which works on the same principle as an emergency external defibrillator on an ongoing basis.

Common misspellings of defibrillator are as follows:

• defibulator
• defibrilator
• defribulator
• difibulator
• defibrulator

What Are the Two Different Types of External AEDs?

Automatic external defibrillators are available for either professional use or public access. Professional use AEDs are those used by trained paramedics and emergency medical technicians. 

Public access AEDS are intended for use in an emergency situation by people who have received little or no training. They are frequently available in public locations such as the following:

• Government buildings
• Community centers
• Schools
• Airports

Due to studies supporting the life-saving potential of public access AEDs, some locations are now required to obtain them. These requirements vary according to state laws.

How Did the Defibrillator Develop Over the 20th Century?

At first, defibrillation was an invasive procedure that only a trained physician could perform. It was necessary to apply the paddles directly to the heart, which required a surgical procedure to open the patient’s chest. 

An electrical engineer named William Kouwenhoven had been working since 1925 to develop a device that could deliver a jolt of electricity to the heart externally, without having to open up the chest. He was trying to come up with a device that power companies could use in the event of the accidental electrocution of workers. 

The idea was that a defibrillator would be available to resuscitate workers on site.

Defibrillator History

Kouwenhoven successfully performed a closed-chest defibrillation on a dog nearly 30 years later, in 1954. Two years after that, in 1956, Paul Zoll used a modification of Kouwenhoven’s design to perform the first successful external defibrillation on a human being. However, these external defibrillators were not portable, and so were impractical for use outside a hospital setting.

It was the mid-1960s before a portable defibrillator was invented by Frank Pantridge, a cardiologist in Northern Ireland sometimes known as the “Father of Emergency Medicine.” 

Though portable, this defibrillator was a bit ungainly, weighing over 150 pounds. This model used car batteries as its source of power, which may have been the reason it was so heavy. By the end of the decade, Pantridge had dramatically improved his design, producing a much lighter device, weighing just over six pounds. Needless to say, the new device was much easier to carry around.

However, while the new defibrillators were more portable, they were still difficult for people who didn’t have medical training to operate. 

The next advancement came in 1978 when the first automatic defibrillator was invented.

What Are the Advantages of an AED?

An AED has the ability to detect ventricular fibrillation and cardiac arrest on its own. If it senses that defibrillation is necessary, it can automatically deliver the necessary electric shock. If it senses that there is no need for defibrillation, it will not activate at all. This is advantageous for several reasons:

1. It is no longer necessary for medical personnel to perform defibrillation. A layperson with no specialized knowledge or training can set up the device, and the machine takes it from there.
2. There is a risk of a dangerous electric shock to both the patient and the person using a defibrillator that is not automatic, especially if the latter does not know what he or she is doing. If someone attempting to administer first aid were to deliver an electric shock to someone not in cardiac arrest, it could stop the heart. The AED removes this danger. It knows when a shock is needed and will not deliver it otherwise.
3. Because of portable AEDs, it is no longer necessary to transport a patient to the hospital for defibrillation. The chances for patient’s survival decrease by 7% to 10% for every minute that he or she remains in cardiac arrest. Therefore, the few minutes that an AED can save could mean the difference between life and death.

What Should You Do if There Is No Defibrillator Available?

As more communities adopt comprehensive AED programs, hopefully this scenario will become less and less common. However, if you believe that a patient is in cardiac arrest and there is no AED available, it is most important to keep the patient’s blood circulating. If you have training in cardiopulmonary resuscitation (CPR), you can perform chest compressions and rescue breathing.

However, even if you do not have the necessary training, you can still perform Hands-Only CPR, which dispenses with the rescue breathing in favor of chest compressions only. 

Using both hands, push hard on the center of the chest in a rapid manner, aiming for two compressions per second for a total of 120 per minute. This simulates the pumping motion of the heart and keeps the blood circulating until help arrives.

Why Is It Important That a Public Access Defibrillator Have FDA Approval?

In 2015, the Food and Drug Administration published a final order requiring that manufacturers of AEDs and their necessary accessories, such as pad electrodes and batteries, file an application for premarket approval. 

The FDA recommends transitioning to an approved defibrillator or, if purchasing one for the first time, checking that it is approved before acquiring it. After February 21, 2021, manufacturers may no longer market AED systems and accessories that do not have approval. As a result, accessories for non-approved systems may no longer be available.

What Does the Future Hold for AEDs?

Since the survival chances for a patient in cardiac arrest are better the sooner that an AED is administered, efforts to make AEDs more accessible should be a priority. 

This may involve an easy-to-use universal registration system for public access AEDs and/or a smartphone app showing where the closest AED is located. Efforts to make AEDs more affordable could mean that people could have private defibrillators in their cars or homes. At the very least, it could mean that AED access becomes available in an even greater number of public places.

People must be made aware of the signs of SCA and become familiar with AEDs and how easy they are to utilize. Most people have no idea what an AED is, even today. This will involve training and awareness campaigns, at least. 

Also, bystanders should know that they are protected under the “Good Samaritan Laws” and will not be held legally responsible for a rescue attempt with an AED. This fear has caused hesitation to attempt a rescue with an AED for many.

Increased FDA regulation of defibrillators may prompt manufacturers to follow the examples of Kouwenhoven, the Hyman brothers, and especially Frank Pantridge to look for methods of improving their product in more creative ways.