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Cardiac Defibrillator

Nihon Kohden 2008

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Contents

Main Functions of a Defibrillator Fibrillation

Defibrillation

Arrhythmias Requiring Defibrillation

Defibrillation and Cardioversion Cardioversion

AED (Automated External Defibrillation)

Monitoring

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Main Functions of a Defibrillator

Defibrillation (most important)

Cardioversion (synchronized defibrillation)

Monitoring

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Fibrillation

Fibrillation= Cardiac muscle cells are excited randomly.

= Heart muscle spasms

= Quivering instead of pumping

Decreased pump function

No circulation of blood

Death

Alive

Cardiac Arrest

Defibrillation by large current!!

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Fibrillation

ECG waveform of Ventricular fibrillation (Vf)

No P, QRS, T-waves = No heart beat

Irregular Shape, Amplitude and Rate

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Defibrillation

= A large current shock normalizes the muscle excitability phases.

= This stops the fibrillations and restores the normal rhythm.

(Image)Defibrillation (large current shock)

Random excitement

Reset the rhythm

Normal rhythm

Defibrillation delivers an electrical shock to stop fibrillation andconvert the abnormal rhythm to a normal rhythm.

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Arrhythmias Requiring Defibrillation

1. Af (Atrial Fibrillation)

2. AFL (Atrial Flutter)

3. VT (Ventricular Tachycardia)

4. VF (Ventricular Fibrillation)

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Atrial Fibrillation (Af)

f-waves on the baseline No P-wave

Irregular R-R

Reduced pumping

/ f-wave

P-wave is missing Irregular R-R

Arrhythmias Requiring Defibrillation

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Atrial Flutter (AFL) F-wave

No P-wave

Irregular R-R

Arrhythmias Requiring Defibrillation

f-waves on the baseline

No P-wave

Irregular R-R

Reduced pumping

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Ventricular Tachycardia (VT)

Sudden excitement goes around the Re-entry Circuit Only ventricular contraction

Greatly decreased cardiac output, depending on the HR

Wide QRS, high heart rate, regular R-R, No P-wave

Arrhythmias Requiring Defibrillation

Very serious condition

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Ventricular Fibrillation (VF)

Irregular excitement everywhere in the ventricles

Just quivering, no contraction

No cardiac output, no circulation

Arrhythmias Requiring Defibrillation

Fatal condition. Needs immediate defibrillation!!

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Defibrillation & Cardioversion

Af / AFL

VF / pulse-less VT Defibrillation

Cardioversion

= Defibrillation should be synchronized with R-wave.

Why? To preventR on T

R on T? If the stimulation is given on the T-wave, the heart

will go to VF.

Shock on TVF

Verydangerous!!!!!

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Cardioversion

Shock in synchronization with R-wave

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AED

Automated External DefibrillationWhen shockable waveform (VF) occurs,

Defibrillator detects the shockable waveform (VF)

and charges energy automatically

Discharge by manually !