Lecture 7
Defibrillator
BIOMEDICAL ENGINEERING DEPARTMENT
University Of Science & Technology
Outlines
Defibrillation Definition
Need of defibrillation.
The principle and mechanism of defibrillation.
Types and classes of defibrillator
The Automated external defibrillator (AED)
The risk and safety procedures
Troubleshooting of defibrillator
Remember this????
Defibrillation Definition
Defibrillation is a process in which an electronic device
sends an electric shock to the heart to stop an extremely
rapid, irregular heartbeat, and restore the normal heart
rhythm.
Defibrillation is a common treatment for
ventricular fibrillation, and pulse less ventricular
tachycardia.
When there is no recognizable rhythm in the heart,
it is ventricular fibrillation
Need of defibrillation.
❖Ventricular fibrillation is a serious cardiac emergency
resulting from asynchronous contraction of the heart
muscles.
❖Due to ventricular fibrillation, there is an irregular
rapid heart rhythm.
Fig. Ventricular fibrillation Fig. Normal heart beat
❖ Energy storage capacitor is charged at relatively
slow rate from AC line.
❖Energy stored in capacitor is then delivered at a
relatively rapid rate to chest of the patient.
❖ Simple arrangement involve the discharge of
capacitor energy through the patient’s own
resistance.
Schematic diagram of a defibrillator
❖ The discharge resistance which the patient
represents as purely ohmic resistance of 50 to 100Ω
approximately for a typical electrode size of
80cm^2.
❖ This particular waveform Fig is called ‘ Lown’
waveform.
❖The pulse width of this waveform is generally 10
ms.
Operator selects energy delivered: 50-360
joules, depends on:
– essential characteristics of patient
– patient’s disease
– duration of arrhythmia
– patient’s age
– type of arrhythmia (more energy required for
v. fib.)
❖ Fibrillations cause the heart to stop
pumping blood, leading to brain damage.
❖ Defibrillators deliver a brief electric
shock to the heart, which enables the
heart's natural pacemaker to regain
control and establish a normal heart
rhythm.
Electrical pattern ECG tracing
❖ Types of Defibrillator electrodes:-
a) Spoon shaped electrode
• Applied directly to the heart.
b) Paddle type electrode
• Applied against the chest wall
c) Pad type electrode
• Applied directly on chest wall
fig: Electrodes used in defibrillator (a) a spoon shaped internal electrode
that is applied directly to the heart. (b) a paddle type electrode applied
against the anterior chest wall.
Pad electrode
Monophasic pulse or waveform Bi-phasic pulse or waveform
❖ There are two general classes of waveforms:
a) Mono-phasic waveform
• Energy delivered in one direction through the
patient’s heart
a) Biphasic waveform
• Energy delivered in both direction through the
patient’s heart
❖ The biphasic waveform is preferred over
monophasic waveform to defibrillate. Why?????
➢ A monophasic type, give a high-energy shock,
up to 360 to 400 joules due to which increased
cardiac injury and in burns the chest around the
shock pad sites.
➢ A biphasic type, give two sequential lower-
energy shocks of 120 - 200 joules, with each
shock moving in an opposite polarity between
the pads.
Internal External
a) Internal defibrillator
• Electrodes placed directly to the heart
• e.g..-Pacemaker
b) External defibrillator
• Electrodes placed directly on the heart
• e.g..- The Automated external defibrillator (AED)
▪ For each minute elapsing between onset of ventricular
fibrillation and first defibrillation, survival decreases by
10%.
▪ defibrillators should be portable, battery operated, small
size.
▪ energy in defibrillators usually stored in large
capacitors.
▪ total energy stored in capacitor:
1
WC = CVC2 Vc = capacitor voltage
2
standby
power charge discharge patient
supply gate
switch is under
operator control
energy timing ECG
storage circuitry monitor
applies shock about 20 ms after
QRS complex, avoids T-wave
❖ AED is a portable electronic device that
automatically diagnoses the ventricular
fibrillation in a patient.
❖Automatic refers to the ability to
autonomously analyse the patient's condition.
❖ AED is a type of external defibrillation
process.
❖ AEDs require self-adhesive electrodes
instead of hand held paddles.
❖ The AED uses voice prompts, lights
and text messages to tell the rescuer
what steps have to take next.
➢ Attach the external and internal paddles if the monitor
reads, "No paddles."
➢ Check to ensure that the leads are securely attached if
the monitor reads, "No leads.“
➢ Connect the unit to AC power if the message reads,
"Low battery."
➢ Verify that the Energy Select control settings are correct
if the defibrillator does not charge.
➢ Change the electrodes and make sure that the
electrodes adapter cable is properly connected if
you receive a message of "PACER FAILURE."
Restart the pacer.
➢ Close the recorder door and the paper roll if the
monitor message reads, "Check recorder”.
THANK YOU!!
