The History of the AED: From Invention to Lifesaving Device

The number of public places one can find an Automated External Defibrillator (AED) in Australia (and the developed world) rises every year. These lifesaving devices are now increasingly found in fitness centers, office spaces, airports, shopping malls, and even in the waiting areas of hospitals, making early defibrillation accessible to the public.

Barring a few key differences, what used to exist only as a defibrillator is now an overwhelmingly automated version, capable of delivering electric shocks to restore normal heart rhythm in cases of sudden cardiac arrest.

There are so many AEDs in the world today, the question everyone should be able to answer is, where is the nearest one?

For medical professionals and first responders trained in resuscitation techniques, using manual defibrillation with electrode pads might be preferable due to the ability to customize treatment. However, the widespread availability of modern AEDs allows even untrained bystanders to perform potentially lifesaving interventions, significantly increasing the chance of survival during a cardiac emergency.

The AED addresses a modern public health challenge. While people no longer die from infectious diseases at the rates they once did, we are living longer, which means we are more susceptible to conditions like ventricular fibrillation—a treatable misfire in the body’s electrical system.

The good news is, in today's world, even someone with zero experience can save another's life with an AED, correcting a shockable rhythm and contributing to the chain of survival.

The AED is one of the most important medical devices of the last century, empowering everyday people to perform lifesaving actions. We have yet to see the full scope of possibilities from this transformative technology.

It started with some pretty crude devices…

 

First Electricity

Leading up to the first electrical medical devices for the heart was the discovery or if you prefer the word harnessing... of electricity in the 18th century.

For most of Humanity’s history leading up the 20th century, the medical role for electricity was to determine if someone had died. A quick zap to the tissue would wake someone who'd passed out. A dead patient would stay dead.

In Europe and Russia, researchers in the 1890s started playing with electricity to revive animals. A pair of physiologists from the University of Geneva, Jean-Louis Prévost and Frederic Batelli began this work with undetermined success.

Others followed their work, but none of that research resulted in a successful case of chest defibrillation in a human being.

Then, in the 1930s, a new York cardiologist, Albert S. Hyman with his brother Charles, created the first artificial pacemaker. It wasn’t a defibrillator as such, but this was our first foray into applying electricity to the heart to keep it going.

Prior to this, doctors might attempt to massage a heart on the operating table to stop a case fibrillation, but results varied. (That's code for it didn't work very well.)

 

First Defibrillator

 

Those varied results were the experience of another cardiac surgeon, Claude Beck, who worked at the University Hospital in Cleveland, Ohio, U.S.A. Sometimes he could massage a heart to defibrillate, but usually, fibrillation meant the surgery was over.

Beck first applied current to the hearts of animals whom he’d placed into ventricular fibrillation, attempting to defibrillate them. He was not done with this research when presented with a case in 1947.

During a surgery on a 14-year-old boy, the patient’s heart stopped. Beck had his assistants retrieve his experimental equipment from his basement, a crude defibrillator, and transistor.

The paddles of Beck’s system were modified spoons with wooden handles to shield him from the shock. They plugged in the transistor and Beck applied the first shock.

It did not work, but the second shock was a success. This marked the first successful closed-chest defibrillation in a human, a breakthrough that gained national attention.

Beck’s crude defibrillator was a significant milestone in the history of AEDs, inspiring others to continue research and development in this field.

 

Portable Defibrillator

The work of Beck inspired others to further his findings. In 1950 Paul M. Zoll (the same Zoll, which is now a household name in AED technology) developed an external pacemaker, designed to stimulate the heart without opening up a patient’s chest.

Zoll's 150-volt system required a medical professional to apply two one-inch diameter metal discs covered in electrode jelly on the right and left sides of the chest. They stayed in place via a rubber strap.

By 1952, Zoll published papers on the success of his resuscitation work with patients suffering from heart block and asystole conditions. It wasn’t perfect though. Patients suffered burns and pain after treatment, but it was better than suffering death.

Zoll’s pacemaker may have been crude, but it was something, and it was portable. It just needed a little work to evolve into a modern AED.

 

Automated External Defibrillation

A man from Northern Ireland, Professor James Francis "Frank" Pantridge, who also happened to be a cardiologist, took Zoll’s idea to the next level.

As a side note, he also happened to be the same person who, with his colleague, Dr. John Geddes, outlined the first standards for cardiopulmonary resuscitation (CPR). On top of that, he introduced the first Mobile Coronary Care Unit (MCCU), which was an early ambulance equipped with portable defibrillators and trained medics aimed at providing care en route to the hospital.

In 1965, Pantridge added a 70-kilo defibrillator to the ambulance, run on car batteries. Again, crude, but it worked.

By 1968, he’d refined that technology in a three-kilo device, made possible by borrowing NASA technology; a mini-capacitor.

It would take decades for defibrillators to become standard in ambulances around the world, but today most ambulances have both a standard defibrillator and an AED.

Today we are at the cusp of incorporating our best drone technologies with our lightest portable AEDs. Researchers in different parts of the world are testing different versions of this system.

The key for moving the needle on saving lives will likely include some sort of machine learning (artificial intelligence) where drones can recognise the symptoms of an arrest before the prospective patient’s symptoms become critical.

If a drone knew before the patient knew, we could see a huge shift in the success rate of treating heart attacks.

When it happens, you can be sure Medshop will be there, continuing its commitment to providing essential first aid and heart-aid solutions.

For those interested in learning more about how Automated External Defibrillators (AEDs) work and how to use them effectively, Medshop offers a comprehensive guide that covers everything from the basic principles of defibrillation to step-by-step instructions for operating an AED during an emergency. This resource is invaluable for both medical professionals and the general public, helping to demystify the process of first aid and early defibrillation. You can access this guide and enhance your AED training by visiting What is a Defibrillator? How AEDs Work and How to Use Them.

 

Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).