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Various Forms and Uses of a DefibrillatorIn the field of medicine, a defibrillator plays a very essential role. When heartbeat becomes dangerously fast and chaotic due to ventricular fibrillation or ventricular tachycardia, defibrillators deliver an electrical shock to the heart to restore a normal heart rhythm. Using it helps prevent cardiac arrest and cardiac death from happening. Patients with cardiomyopathy, arrhythmogenic right ventricular dysplasia, QT syndrome or survivors of sudden cardiac death require defibrillation.
For life-threatening cardiac arrhythmias ventricular fibrillation and pulseless ventricular tachycardia, defibrillation is the definitive treatment. In this treatment, a defibrillator is used to deliver a therapeutic dose of electrical energy to the affected heart. Before the affected heart suffers from sudden cardiac arrest, defibrillation works to restore normal heart rhythms. It depolarizes a critical mass of the heart muscle, ends the arrhythmia, and reestablishes normal sinus rhythm.
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There are different forms and sizes of defibrillators. Those types you see in a hospital are called manual defibrillators or defibrillator paddles or, and they can only be operated by healthcare professionals. On the other hand, the AED can be used by lay people with only less training, which is handy for emergency purposes where no healthcare professional is around. ICDs or implantable cardio-verter defibrillators are implantable in the patients chest.
There are both internal and external manual defibrillators. The clinician diagnoses a cardiac condition through external units that work in conjunction with electrocardiogram readers. After the diagnosis, the clinician then decides on the charge in joules to deliver to the patients chest, and sends the shock through pads or paddles. Medical knowledge and experience is needed to perform this treatment, thus they are only generally found in hospitals and some ambulances.
Similar to the external version are manual internal defibrillators. However, for these units, the charge is sent by internal leads in direct contact to the heart. When the heart is experiencing an abnormal rhythm, the leads detect it and deliver the required electrical shock. Typically, you can see these units in operating theatres where the chest is likely to be open.
REVIEW ARTICLE: Current Concepts: Implantable Cardioverter-Defibrillators after Myocardial Infarction (New England Journal of Medicine)REVIEW ARTICLE: Current Concepts: Implantable Cardioverter-Defibrillators after Myocardial Infarction (New England Journal of Medicine)
Patients with a history of myocardial infarction and a reduced ejection fraction are at increased risk for life-threatening ventricular arrhythmias. Which of these patients are the most appropriate candidates for implantable cardioverter-defibrillator (ICD) therapy is unclear. Factors influencing the decision are discussed.
For emergency cases where no healthcare professional is around, AEDs are available. Automated external defibrillators are based on computer technology to study the heart rhythm and advise whether a shock is necessary. Unlike manual types, AEDs can be used by lay persons with less training. PADs or public access defibrillators are AEDs that can be found in public places including airports, hotels, and shopping centers. There are also some AEDs which are held by trained personnel who will attend incidents.
ICDs or implantable cardio-verter defibrillators are another form. Such units are implantable (patients chest), and can perform the same function as pacemaking. ICDs regularly check on the patients heart rhythm, and if required, also corrects arrhythmia or abnormal heart rhythm based on the devices programming. The pacemaker can be used together with ICDs for events that involve treating complex arrhythmias.
Those are some of the various forms and uses of a defibrillator. Although they vary in shapes and sizes, all of them aim to convert an unhealthy cardiac rhythm into a more standard rhythm. It plays a significant role in saving lives of people, whether the unit is automated or manual, internal or external, or used by medical professionals or lay men.
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First defibrillator implanted at NMC - Newton KansanFirst defibrillator implanted at NMC - Newton Kansan
This story first appeared in the Nov. 6 edition of the Kansan. The area’s first cardioverter-defibrillator was successfully implanted in the chest of a Newton patient threatened with sudden cardiac arrest. The procedure was performed Aug. 26 at ...