Umair Gaines
Defibrillators are devices that deliver an electric shock to the heart, allowing it to recover from a potentially fatal abnormal heart rhythm, or arrhythmia. The devices are connected to the patient via a pair of electrodes, commonly referred to as paddles, which are coated in electrically conductive gel to ensure a good connection. The paddles deliver a therapeutic amount of electric current to the heart at a specific point in the cardiac cycle, restoring its electrical conduction function.
| Characteristics | Values |
|---|---|
| Name | Defibrillator |
| Other Names | Electric paddles, electrodes, paddles |
| Purpose | To save lives in case of cardiac arrest |
| Function | Provides an electrical charge to stop the heart's abnormal rhythm and allow it to get back to a normal rhythm |
| Usage | For sticky pads, push a button on the machine to give the shock. For paddles, push the button on each paddle at the same time. |
| Use Cases | Ventricular tachycardia (with no pulse), ventricular fibrillation, atrial fibrillation, atrial flutter, supraventricular tachycardias |
| Electrode Types | Paddle electrodes, self-adhesive electrodes, multifunction electrodes (MFE) |
| Electrode Gel Types | Wet gel, solid gel |
| Electrode Pad Size | Reduced over the last 20 years due to miniaturization of electronic parts |
| Placement | One electrode to the left of the nipple, the other ("apex" paddle) over the left precordium, or posterior to the heart in the right interscapular region |
| Alternative Treatment | Chemical cardioversion or pharmacological cardioversion using antiarrhythmic medications |
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What You'll Learn
Defibrillator paddles are also called electrodes
In the early 1900s, defibrillator electrodes were referred to as "paddles" by doctors because they had two large paddles that would be held against the patient's open heart during surgery. It was not until much later that the defibrillation paddles became small and portable enough to be applied to the skin of patients experiencing sudden cardiac arrest (SCA). The paddles are now appropriately referred to as electrodes.
The defibrillator is connected to the patient through a pair of electrodes coated with electrically conductive gel to ensure a good connection and to minimise electrical resistance, also known as chest impedance. The gel may be either wet (similar to surgical lubricant) or solid (similar to gummi candy). Solid gel is more convenient as it does not need to be cleaned off the skin after defibrillation, but it presents a higher risk of burns. Paddle electrodes, the first type of electrode developed, do not come with gel, which must be applied separately. Self-adhesive electrodes, on the other hand, come pre-fitted with gel.
The placement of the electrodes is important for effective defibrillation. The first electrode is placed below the right collarbone, while the second electrode is placed to the left of the nipple, with the centre of the electrode in the midaxillary line. This line runs vertically down from the armpit, dividing the body into its anterior (front) and posterior (back) halves. Alternatively, the "apex" paddle can be placed anterior, over the left precordium, and the "sternum" paddle can be placed posterior to the heart in the right interscapular region.
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They deliver a shock dose of electricity to the heart
The devices used to deliver a shock dose of electricity to the heart are called defibrillators. They are used to treat life-threatening cardiac arrhythmias, specifically ventricular fibrillation and non-perfusing ventricular tachycardia. Defibrillators can be internal or external, and they work by delivering an electrical charge to the heart to stop abnormal heart rhythms and allow the heart to start beating normally again.
The defibrillator electrodes, often referred to as paddles, are attached to the defibrillator machine. In the early 1900s, defibrillator electrodes were large paddles that were held against the patient's open heart during surgery. With the invention of the automated external defibrillator (AED), the paddles became smaller and could be applied to the external skin of the patient. The AED contains technology for analysing heart rhythms and can be used by untrained or briefly trained laypersons.
When using paddles, a button on each paddle is pressed simultaneously to deliver the shock. The paddles should be kept separate to ensure that the current does not travel along the chest wall and "miss" the heart. The paddles are coated with electrically conductive gel to ensure a good connection and minimise electrical resistance or chest impedance, which could burn the patient. The gel can be wet or solid, with solid gel being more convenient as it does not need to be cleaned off the skin after defibrillation.
The placement of the paddles is important for effective defibrillation. One paddle should be placed to the left of the nipple, with the centre of the electrode in the midaxillary line. The alternative placement is to position one paddle anterior, over the left precordium, and the other paddle posterior to the heart in the right interscapular region.
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This stops chaotic electrical activity and resets the heart
The "electric paddles" you are referring to are electrodes that are part of a machine called a defibrillator. Defibrillators are used to deliver a therapeutic amount of electric current to the heart, which can save your life if you are in cardiac arrest.
Defibrillators use an electrical charge to stop the heart's abnormal rhythm and allow it to start beating normally again. This process is known as defibrillation or cardioversion. It involves delivering a dose of electric current (often called a counter-shock) to the heart, which depolarizes a large amount of the heart muscle and ends the arrhythmia.
The defibrillator paddles are placed on the patient's chest, with the first electrode placed to the left of the nipple, and the second electrode placed in the midaxillary line. The paddles deliver a controlled electric shock, which briefly stops the heart muscle from moving. This allows the heart to generate a new electrical impulse and start beating in a normal rhythm.
The use of defibrillators has been popularized by Hollywood in medical dramas, but it is important to note that they cannot shock a heart back into action after it has stopped beating. Defibrillators are designed to stop the irregular beating and reset the heart to beat regularly. When a patient flatlines, it is time for CPR and drugs, not defibrillation.
In addition to external defibrillators, there are also internal defibrillators, also known as implantable cardioverter defibrillators (ICDs). These devices are implanted in the body and can deliver a shock when a fatal heart rhythm is detected. ICDs are often used to treat ventricular fibrillation and can help prevent future episodes.
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The paddles are placed on the chest or directly on the heart
The devices that are placed on the chest or directly on the heart to deliver an electric shock are called defibrillators. They are used to treat life-threatening cardiac arrhythmias, specifically ventricular fibrillation and non-perfusing ventricular tachycardia. Defibrillators can be internal or external.
Internal defibrillators are often used during or after cardiac surgery, such as a heart bypass. They consist of round metal plates that come into direct contact with the myocardium. These are mostly used in operating rooms and, in rare cases, in emergency rooms during open-heart surgery.
External defibrillators, also known as automated external defibrillators (AEDs), are designed for use by untrained or briefly trained laypersons. They can be further categorized into sticky pads and handheld paddles. For sticky pads, a button on the machine is pushed to deliver the shock. For handheld paddles, a button on each paddle is pushed simultaneously.
The paddles should be placed carefully to ensure that the current does not travel along the chest wall and "miss" the heart. One method is to place the second electrode to the left of the nipple, with the centre of the electrode in the midaxillary line. This imaginary line runs vertically down from the armpit, dividing the body into anterior (front) and posterior (back) halves. An alternative placement is to position one paddle ("apex") anterior, over the left precordium, and the other paddle ("sternum") posterior to the heart in the right interscapular region.
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Defibrillators are used to treat ventricular fibrillation
Defibrillators are medical devices that deliver an electric shock to the heart to restore a normal heartbeat. They are used to treat ventricular fibrillation, a condition where the heart's ventricles (lower chambers) experience abnormal electrical activity, causing the heart muscle to quiver and contract irregularly. This results in a loss of effective pumping ability, leading to cardiac arrest and rapid deterioration.
Ventricular fibrillation is a life-threatening condition that requires immediate medical attention. Defibrillators are an essential tool in treating this condition and can mean the difference between life and death. The device works by delivering a controlled electrical shock to the heart, which briefly stops the heart muscle from moving. This interruption allows the heart to generate a new electrical impulse and establish a normal rhythm.
The defibrillator's electrodes, also known as paddles, are placed on the patient's chest to deliver the shock. One paddle is positioned below the right shoulder, while the other is placed below the left nipple. This placement ensures that the electrical current reaches the heart effectively. It is crucial to remove any clothing from the patient's chest and ensure that the chest is dry before applying the paddles.
Defibrillators come in different types, including external, transvenous, and implanted (implantable cardioverter defibrillator or ICD). External defibrillators, such as automated external defibrillators (AEDs), are commonly found in public places like airports. These devices can analyse heart rhythms, determine if a shock is needed, and provide verbal instructions for use. They are designed to be used by lay responders or bystanders with little to no training.
Implanted defibrillators, on the other hand, are devices that are surgically placed inside the body. These ICDs continuously monitor the heart's rhythm and deliver a shock when a fatal rhythm is detected. They are similar to pacemakers in their ability to keep the heart beating but have the added capability of providing a shock when needed. Wearable cardioverter defibrillators are also available, which are worn like a vest under clothing, allowing for early detection and treatment of abnormal heart rhythms.
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Frequently asked questions
The heart electric paddles are called defibrillator paddles. They are part of a machine called a defibrillator.
Defibrillator paddles deliver a therapeutic amount of electric current to the heart at a specific point in the cardiac cycle. This restarts the heart by restoring its electrical conduction function and allowing the heart to generate an electrical impulse to start a normal rhythm.
There are manual internal defibrillators, automated external defibrillators (AEDs), wearable cardioverter defibrillators, and implantable cardioverter defibrillators (ICDs).
