Defibrillation therapy is an emergency medical procedure that uses high-energy electrical currents to restore normal heart rhythm, primarily used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless electrical activity. This technique interrupts abnormal heartbeats with a sudden electric shock, prompting the heart to resume coordinated contractions.
In emergencies such as heart attacks, cardiac arrest, or severe arrhythmias, defibrillation can significantly improve patient survival rates. The key is to minimize the time from "shock to cardiac recovery," which is why it is commonly used in emergency settings and intensive care units.
Defibrillation is mainly divided into "External Defibrillation" and "Implantable Cardioverter-Defibrillator (ICD)." External defibrillation is performed using adhesive pads or portable defibrillators, while ICDs are implanted devices placed permanently within the chest.
Primarily used in critical situations such as Ventricular Fibrillation (VF), Pulseless Ventricular Tachycardia (VT), and certain cases of cardiac arrest. In unconscious or comatose patients, if the ECG shows reversible arrhythmias, immediate defibrillation can significantly increase survival chances.
For patients post-surgery or with heart failure who experience recurrent fatal arrhythmias, implantation of an ICD may be recommended as a preventive measure. This decision should be made after assessment of long-term risks by a cardiologist.
External defibrillation requires confirming the patient has no pulse or breathing. The operator analyzes the heart rhythm with the defibrillator and selects the energy level based on the displayed "shockable rhythm." The initial dose for adults is usually 200-360 joules, with possible adjustments in subsequent shocks.
Implantable ICDs require surgical implantation under the skin, and the device automatically determines whether to deliver a shock based on preset parameters. Patients need regular follow-up to adjust settings and should avoid strong magnetic fields or high-voltage power sources.
This treatment can terminate fatal arrhythmias within seconds. Studies show that timely defibrillation can increase survival rates from cardiac arrest by 40-60%. The widespread use of portable AEDs allows non-professionals to participate in emergency rescue efforts.
Possible side effects include skin burns, rib fractures, or myocardial tissue damage. About 5-10% of patients may experience transient memory confusion or anxiety reactions. Repeated shocks may increase the risk of myocardial injury, so energy settings must be strictly followed.
Serious complications include:
Contraindications include the presence of metal objects near implantable electronic devices, contact with undischarged metal objects, and certain cardiac anatomical abnormalities. Before operation, it must be confirmed that the patient is not experiencing "Pulseless Electrical Activity (PEA)."
During surgery, ensure the patient is out of water to prevent short circuits. Patients with ICDs should avoid MRI and other strong magnetic fields and undergo regular cardiac function assessments.
Defibrillation should be used in conjunction with antiarrhythmic drugs (such as amiodarone), but caution is needed as these drugs may alter ECG patterns and affect defibrillator interpretation. When using airway intubation or extracorporeal membrane oxygenation (ECMO), adjustments in electrode placement are necessary.
When combined with pacemakers, ensure that settings do not conflict. Patients with previous chest surgery may have altered anatomy affecting shock efficacy, requiring adjustments in electrode placement angles.
Research shows that each minute delay in defibrillation decreases survival by 7-10%. Large clinical trials confirm that early AED use in out-of-hospital cardiac arrests results in survival rates over 30%. ICD implantation reduces the risk of cardiac sudden death by 60-70% within five years.
The American Heart Association (AHA) emphasizes that defibrillation should be combined with cardiopulmonary resuscitation (CPR). Large registry studies indicate that patients who use defibrillators correctly have higher rates of good neurological function at discharge.
Short-term alternatives include medication treatments (such as adrenaline, magnesium sulfate) or pacemakers, but these cannot immediately terminate fatal arrhythmias. Long-term management options include radiofrequency ablation or surgical correction of cardiac structural abnormalities, but these are not emergency solutions.
Non-invasive options like wearable cardiac monitors can predict risk but cannot replace immediate electrical shocks. All alternatives should be combined with regular cardiac evaluations and lifestyle modifications.
Before defibrillation, patients should follow medical advice to discontinue medications that affect heart rhythm (such as anticoagulants) and fast for 6 to 8 hours prior to the procedure. The medical team will evaluate the patient's cardiac condition and arrange ECG or blood tests to ensure safety. Patients with diabetes or on long-term medication should inform healthcare providers in advance.
Will the defibrillation process be painful?The procedure involves brief anesthesia, and the patient remains unconscious throughout, so no pain is felt. After waking, there may be short-term dizziness or muscle soreness, which usually resolves within a few hours. Medical staff will monitor heart rhythm and vital signs continuously to ensure safety.
What are the possible side effects after surgery? How to cope?A small number of patients may experience skin redness or temporary burns at electrode contact sites, which can be alleviated with ointments. Some may have palpitations or dizziness; if symptoms persist beyond 24 hours or worsen, medical attention should be sought immediately. It is recommended to avoid driving or operating machinery within 24 hours post-surgery until the body adapts.
Do I need to adjust my daily habits after surgery?Doctors usually advise avoiding strenuous exercise for one week post-operation and to monitor heart rhythm regularly. If you have hypertension or hyperlipidemia, continue managing these conditions. Quitting smoking, limiting alcohol, and maintaining a low-salt, low-fat diet can reduce the risk of arrhythmia recurrence.
What is the success rate of defibrillation?The success rate depends on the type of arrhythmia and overall health. The success rate for atrioventricular tachycardia is approximately 80-90%, while ventricular fibrillation is lower but essential in emergency rescue. Regular follow-up and medication adherence can improve long-term control. The doctor will adjust subsequent treatment plans based on recurrence risks.
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