Otis Singleton
The Internet of Medical Things (IoMT) is a collection of medical devices and applications that connect to healthcare information technology systems through online networks. These devices have become increasingly popular in recent years, especially during the COVID-19 pandemic, as they enable remote healthcare capabilities and limit the number of patients traveling to healthcare facilities. One such device is the defibrillator, a portable external device that applies an electric charge or current to the heart to restore a normal heartbeat. Defibrillators are used to treat life-threatening cardiac arrhythmias, specifically ventricular fibrillation and ventricular tachycardia.
| Characteristics | Values |
|---|---|
| Name | Defibrillators |
| Other Names | Automated External Defibrillator (AED), Cardioverter Defibrillator, Wearable Cardioverter Defibrillator (WCD), Implanted Cardioverter Defibrillator (ICD) |
| Function | Applies an electric charge or current to the heart to restore a normal heartbeat |
| Use Case | Used to treat ventricular fibrillation and ventricular tachycardia |
| Type | Wearable, Implanted, External |
| Power Source | Battery |
| Adhesion Mechanism | Adhesive defibrillator pads |
| Related Devices | Pacemakers |
| Technology | IoMT (Internet of Medical Things) |
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What You'll Learn
Defibrillators
There are several types of defibrillators, including automated external defibrillators (AEDs), implanted cardioverter defibrillators (ICDs), and wearable cardioverter defibrillators (WCDs). AEDs are lightweight, battery-operated, portable devices that can be found in many public spaces and used by anyone in an emergency. They are equipped with adhesive defibrillator pads that are applied to the chest to allow an electrical current to pass through to the heart. ICDs, on the other hand, are small devices that are surgically placed in the chest. They are preprogrammed to automatically detect cardiac arrest or a life-threatening arrhythmia and deliver an electric shock if needed. WCDs are vests with a rechargeable battery that can be worn by at-risk patients. They function similarly to ICDs by automatically detecting a life-threatening rhythm and delivering an electrical charge to restore a normal rhythm.
The process of defibrillation involves delivering a dose of electric current or counter-shock to the heart, which depolarizes a large amount of the heart muscle and ends the arrhythmia. This allows the body's natural pacemaker in the sinoatrial node of the heart to re-establish a normal sinus rhythm. It is important to note that defibrillators cannot help someone who is already in asystole, and in such cases, CPR and medication are necessary. Additionally, defibrillators should be used within 10 minutes of the onset of an abnormal heart rhythm for the best chances of success.
The use of defibrillators has evolved over time, with serial production of pulse defibrillators beginning in the 1950s. Today, defibrillators are widely used by emergency medical services personnel and are even recommended for individuals with a high risk of cardiac arrest to have at home. While they can be life-saving devices, it is important to note that recovery from cardiac arrest and defibrillation can be a long-term process, often requiring physical therapy and other forms of rehabilitation.
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Implanted cardioverter defibrillators (ICDs)
ICDs constantly monitor heartbeats to ensure they are steady and deliver a high-energy electric charge or shock to the heart to stop the arrhythmia or restart the heart after cardiac arrest. This process is called defibrillation and can help prevent sudden death in people with a high risk of a life-threatening arrhythmia. The ICD may have one, two, or three electrodes, and most ICDs have a built-in pacemaker. The pacemaker function sends tiny electric signals to the heart when the heartbeat is too slow, and the defibrillation function gives shocks to stop the abnormal rhythm when the heartbeat is too fast or chaotic.
In addition to the standard ICD, there is a special kind of ICD called a subcutaneous ICD. This device has a lead that is placed in the tissue to the left of the breastbone rather than in the heart. The procedure to implant an ICD typically takes two to three hours, and most people who have an ICD implanted are able to go home from the hospital in one day and return to their normal activity level within four to six weeks. It takes time and effort to get used to living with a defibrillator, and regular check-ups are necessary to monitor the device and check the battery life.
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Wearable cardioverter defibrillators (WCDs)
WCDs are vests with a rechargeable battery. They are designed to monitor the patient 24 hours a day and can automatically deliver a biphasic shock if VF or VT is detected. The connection between the defibrillator and the patient consists of a pair of electrodes, each provided with electrically conductive gel to ensure a good connection and minimize electrical resistance. WCDs are intended for patients with a known transient risk for SCD and meant for temporary use. They are usually available in public places and first responder ambulances.
WCDs are a newer type of medical device that helps ensure that people at high risk of experiencing SCA have an essential layer of protection against a deadly event. They are also a temporary therapeutic option in case an implantable cardioverter defibrillator (ICD) cannot be implanted immediately. ICDs are small devices surgically placed in the chest and are preprogrammed to automatically detect cardiac arrest or a life-threatening arrhythmia. They then send a high-energy electric charge to stop the arrhythmia or restart the heart after cardiac arrest.
The first wearable cardioverter defibrillator (WCD) was developed by M. Stephen Heilman and Larry Bowling, who founded LIFECOR in 1986. The device was named LifeVest® and was extensively tested for three years in multinational clinical trials in the United States and Europe. In 2001, the FDA approved the LifeVest wearable cardioverter defibrillator (model 2000) for use in adult patients who are at high risk for SCD and are not suitable candidates for an ICD. In 2015, the FDA also approved the use of the WCD in children who met similar criteria.
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Internet of Medical Things (IoMT)
The Internet of Medical Things (IoMT) is a powerful tool that addresses various healthcare needs and challenges. IoMT is a complex ecosystem of medical devices, wearables, and sensors that work together to enhance healthcare delivery. It is a groundbreaking convergence of medical devices and the internet, poised to revolutionize the healthcare industry.
IoMT devices continuously gather and process medical data, providing a comprehensive view of patients' health and enabling accurate diagnoses and timely interventions. These devices are equipped with sensors that capture vital health information such as heart rate, blood pressure, and glucose levels. This data is then transmitted to healthcare providers for analysis, facilitating informed decision-making and personalized patient care.
One example of an IoMT device is a continuous glucose monitor, which helps patients understand how their eating habits impact their blood sugar levels in real time. Other examples include smartwatches for ECG and heart rate monitoring, such as the Apple Watch and Fitbit, and neuromodulation devices that control neural functions for the treatment of chronic pain and epilepsy. IoMT also includes point-of-care kiosks, which provide basic diagnostic tests and telemedicine consultations in remote locations.
The benefits of IoMT extend beyond individual patient care. IoMT enhances patient care, improves outcomes, and reduces costs. It enables real-time data exchange, remote monitoring, and efficient healthcare operations. With the increasing prevalence of chronic conditions, IoMT provides continuous monitoring and management solutions, such as cardiac implants that offer real-time data to effectively manage these conditions.
The integration of technologies such as artificial intelligence (AI), machine learning, and big data analytics enhances IoMT by improving data processing capabilities and providing deeper insights into patient health. These technologies enable predictive analytics, allowing for preemptive interventions and improved patient outcomes.
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Cardiopulmonary resuscitation (CPR)
One of those electric medical things is an automated external defibrillator (AED). AEDs are battery-powered, adhesive defibrillator pads that are applied to the chest to allow an electrical current to pass through to the heart to reset its normal electrical current.
CPR can be performed by healthcare providers and those trained in conventional CPR, which involves chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths. Chest compressions should be performed at a rate of 100 to 120 per minute and to a depth of at least 2 inches (5 cm) for an average adult, while avoiding excessive chest compression depths (greater than 2.4 inches or 6 cm).
For the general public or bystanders who witness an adult suddenly collapse, compression-only or Hands-Only CPR can be performed. This involves only chest compressions without mouth-to-mouth breaths and is recommended for use by people who see a teen or adult suddenly collapse in an out-of-hospital setting.
It is important to note that the only absolute contraindication to CPR is a do-not-resuscitate (DNR) order or other advanced directive indicating a person's desire not to be resuscitated in the event of cardiac arrest. CPR, in its most basic form, can be performed anywhere without the need for specialized equipment, and proper technique is essential.
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Frequently asked questions
They are called defibrillators.
Defibrillators are devices that apply an electric charge or current to the heart to restore a normal heartbeat.
Defibrillators can be used by medical professionals or untrained users.
