Cardioverter Defibrillator
AED Will Sustain Until Emergency Personnel Arrive
Defibrillator: Its Different Forms and UsesA defibrillator is one very essential medical device. When a patient experiences ventricular fibrillation or ventricular tachycardia and thus dangerously fast and chaotic heartbeat, defibrillation is done to restore a normal heart rhythm. Also, patients with arrhythmogenic right ventricular dysplasia, cardiomyopathy, QT syndromes and survivors of sudden cardiac death need defibrillation. Using defibrillators help prevent cases of cardiac arrest and cardiac death.
Defibrillation is the best treatment for life-threatening cardiac arrhythmias ventricular fibrillation and pulseless ventricular tachycardia. It works by sending a therapeutic jolt of electrical energy to the affected heart through a device called a defibrillator. This treatment depolarizes a critical mass of the heart muscle, stops the arrhythmia, and reestablishes normal sinus rhythm. It restores normal heart rhythms before the affected heart suffers from sudden cardiac arrest.
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Defibrillators come in various shapes and sizes. What you commonly see in the hospital are called manual defibrillators or defibrillator paddles, and they are used by healthcare professionals. The AED or automatic external defibrillators are those that allow lay people to operate it with only minimal training. This is perfect for emergency uses. Implantable cardioverter defibrillators or ICDS are implanted in a patient’s chest.
Manual defibrillators can either be external or internal. External types work with electrocardiogram readers, which allow the clinician to diagnose a cardiac condition. Then, basing on previous knowledge and experience, the clinician will deliver the appropriate charge in joules through pads or paddles on the patient’s chest. Doing so requires detailed medical knowledge, and for this reason, these units are usually found only 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 purposes, automated external defibrillators are available. These units rely on computer technology to analyze the heart rhythm and advise whether a shock is needed. AEDs can be used by lay persons, who call for little training. Generally, they are held by qualified personnel who will attend incidents or are PADs or public access defibrillators that can be found in airports, hotels, shopping centers, and corporate or government offices, among others.
ICDs or implantable cardio-verter defibrillators are another form. Such units are implantable (patient’s chest), and can perform the same function as pacemaking. ICDs regularly check on the patient’s heart rhythm, and if required, also corrects arrhythmia or abnormal heart rhythm based on the device’s programming. The pacemaker can be used together with ICDs for events that involve treating complex arrhythmias.
A defibrillator can come in various forms and uses. However, no matter how different they are in shape and size, they all aim to restore an unhealthy cardiac rhythm into a more normal rhythm. So, whether it’s automatic or manual, internal or external, or used only by medical professionals or lay men, it plays a significant role in saving lives of people.
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