TED-­‐Time	
  and	
  life-­‐saving	
  External	
  
Defibrillator:	
  a	
  Home	
  AED	
  
Inventors	
  and	
  patent	
  hol...
Sudden	
  Cardiac	
  Arrest	
  
The	
  Need	
  

•  Sudden	
  Cardiac	
  Arrest	
  (SCA)-­‐ventricular	
  fibrilla<on	
  (V...
Sudden	
  Cardiac	
  Arrest	
  
The	
  Evolu<on	
  

•  External	
  Defibrillators-­‐	
  used	
  in	
  hospitals,	
  since	...
Current	
  Solu<ons	
  	
  
AICD	
  

• 
• 
• 
• 
• 
• 

VERY	
  HIGH	
  COST	
  	
  (20,000$)	
  
NEEDS	
  OPERATIVE	
  P...
Current	
  Solu<ons	
  	
  
AEDs-­‐	
  in	
  public	
  places	
  

• 

HIGH	
  COST	
  PER	
  UNIT	
  (1000-­‐2000$)	
  

...
Current Solutions
AED	
  

•  MAINTENANCE	
  	
  COST	
  IS	
  
HIGH-­‐2363$/YEAR	
  
•  AS	
  REPORTED	
  BY	
  ZOLL	
  
TED	
  Solu<on	
  
Main	
  ideas	
  
•  Use	
  the	
  AC	
  mains	
  as	
  source	
  of	
  energy	
  
•  Shape	
  by	
  co...
A Typical Monophasic Waveform
Basic Output Waveform Classic Style

0

5

10

15

20

25

Time (msec)

30

35

40

45

50
TED	
  Solu<on	
  
A	
  Typical	
  	
  AC-­‐derived	
  Biphasic	
  Waveform	
  
Basic Biphasic Output Waveform Classic Sty...
TED	
  Solu<on	
  
Advantages	
  
•  Immediately	
  opera<onal	
  
•  No	
  delay	
  in	
  repeated	
  opera<on	
  allowin...
Leading to …
•  Lower cost per unit
•  Maintenance Free
•  Reliable

Therefore ideal for Use at Home
Preferable to existin...
Sudden	
  Cardiac	
  Arrest	
  
	
  	
  

The	
  market	
  

•  It	
  should	
  be	
  recommended	
  by	
  physicians	
  t...
Sudden	
  Cardiac	
  Arrest	
  
AICD	
  
Automa<c	
  Internal	
  
Cardiac	
  Defibrilla<on	
  
(X20)	
  
	
  
LVD	
  
Leo	
...
Sudden	
  Cardiac	
  Arrest	
  
The	
  market	
  

Ideally	
  a	
  personal	
  AED	
  should	
  be	
  present	
  in	
  eve...
First	
  Animal	
  Study:	
  Defibrilla<on	
  
5	
  small	
  pigs	
  (30-­‐40	
  Kg	
  body	
  weight)	
  
General	
  anest...
First	
  Animal	
  Study:	
  Defibrilla<on	
  
49	
  J	
  AC	
  

Successful	
  Defibrilla<on	
  
Successful	
  Defibrilla<on	
  
50 J DC
An Advanced Biphasic Waveform
Advanced Biphasic Output Waveform

0

5

10

15

20

25

Time (msec)

30

35

40

45

50
Comparison	
  of	
  AC	
  and	
  DC	
  DFT	
  in	
  each	
  
pig	
  	
  

a

b
First	
  Animal	
  Study:	
  Defibrilla<on	
  
DFT	
  with	
  MAC	
  versus	
  DC	
  Shocks	
  
First	
  Animal	
  Study:	
  Defibrilla<on	
  
Rescue	
  Shock-­‐18	
  sec	
  aoer	
  first	
  shock	
  
Second	
  Animal	
  Study	
  
• 
• 
• 
• 
• 
• 

Six	
  rats	
  
Mean	
  weight	
  491.7±123.7	
  grams	
  
mid	
  LAD	
  ...
Second	
  Animal	
  Study:	
  External	
  pacing	
  
Pacing	
  

8	
  Volts	
  Threshold	
  

Sinus	
  
Conclusions	
  
•  Modified	
  AC	
  Shock	
  Defibrilla<on	
  is	
  feasible	
  and	
  as	
  effec<ve	
  
as	
  the	
  stand...
Publica<ons	
  
Europace	
  
Shimon	
  Rosenheck,	
  Shraga	
  Gorni,	
  Ioni	
  
Katz,	
  Asaf	
  Rabin,	
  Uri	
  Shpoli...
Thank	
  you	
  
Upcoming SlideShare
Loading in...5
×

TED External Home Defibrillator for Home Consumer innovation

779

Published on

Sudden Cardiac Arrest (SCA)-ventricular fibrillation (VF)- kills 350000 people in the US alone, each year, about 3 million worldwide, at the prime-time of their life, mostly witnessed and at home /office.
Defibrillation procedure must be performed as soon as possible: survival decreases by 10% for every minute of delay-therefore ambulance help at home-too late! At present, only very few of SCA victims at home survive and many- in coma, in nursing homes.
TED is a home consumer solution that is much more affordable and reliable.
The novelty in our defibrillator device is based on a computerized modification of the alternating current, from the mains , existing in every home, to the FDA-approved biphasic defibrillatory wave .

Inventors and patent holders:
Prof. A. Teddy Weiss & team at Hadassah Hospital, Jerusalem, Israel
Contact: atweiss@hadassah.org.il

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
779
On Slideshare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
6
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

TED External Home Defibrillator for Home Consumer innovation

  1. 1. TED-­‐Time  and  life-­‐saving  External   Defibrillator:  a  Home  AED   Inventors  and  patent  holders:       Prof.  A.  Teddy    Weiss  &  team  at  Hadassah   Hospital,  Jerusalem,  Israel      atweiss@hadassah.org.il  
  2. 2. Sudden  Cardiac  Arrest   The  Need   •  Sudden  Cardiac  Arrest  (SCA)-­‐ventricular  fibrilla<on  (VF)-­‐    kills  350000  people  in   the  US  alone,  each  year,  about  3  million  worldwide,  at  the  prime-­‐<me  of  their   life,  mostly  witnessed  and  at  home  /office.   •  Defibrilla<on  procedure  must  be  performed  as  soon  as  possible:  survival   decreases  by  10%  for  every  minute  of  delay-­‐therefore  ambulance  help  at  home-­‐ too  late!  At  present,  only  very  few  of  SCA  vic<ms  at  home  survive  and  many-­‐  in   coma,  in  nursing  homes.   •  TED  is  a  home  consumer  solu<on  that  is  much  more  affordable  and  reliable.              The  novelty  in  our  defibrillator  device  is  based  on  a  computerized  modifica<on  of     the  alterna<ng  current,  from  the  mains  ,  exis<ng  in  every  home,  to  the  FDA-­‐ approved  biphasic    defibrillatory    wave.    
  3. 3. Sudden  Cardiac  Arrest   The  Evolu<on   •  External  Defibrillators-­‐  used  in  hospitals,  since  1960s   •  AICD-­‐for  the  very  high  risk  pts-­‐since  1980s   •  AED  used  by  trained  emergency  personnel  have  become  an   essen<al  link  in  the  “Chain  of  Survival”(CPR),  since  1980s         •  The  logical  extension  of  the  AED  concept  is  the  Public  Access   Defibrillator  (in  airplanes,  airport,  casino)-­‐infrequent  use,  by   laymen  and  since  safe-­‐  FDA  approved  its  use  at  home-­‐2000   •  A  further  logical  extension  of  the  Public  Access  Defibrillator  is  our   TED  -­‐  Personal  Defibrillator  to  be  used  at  home/office  
  4. 4. Current  Solu<ons     AICD   •  •  •  •  •  •  VERY  HIGH  COST    (20,000$)   NEEDS  OPERATIVE  PROCEDURE  (RISKY)   MAY  DELIVER  INAPROPRIATE  SHOCKS   NEEDS  CARE  AND  REPLACEMENT   PSYCHOLOGIC  BURDEN   END-­‐OF-­‐LIFE  PROBLEMS  
  5. 5. Current  Solu<ons     AEDs-­‐  in  public  places   •  HIGH  COST  PER  UNIT  (1000-­‐2000$)   •  HIGH  COST  FOR  MAINTENANCE  (about  2000$  PER  YEAR).            -­‐-­‐  SINCE  INTENDED  FOR  LONG  STORAGE-­‐  MAY  NEVER  BE  USED  OR   CHECKED        -­‐-­‐WHEN  NEEDED  IN  EMERGENCY-­‐MAY  NOT  WORK:  BATTERY  OR   CAPACITOR  FAILURE   •  NO  PACING  CAPABILITIES  IN  CASE  OF  VERY  SLOW  HEART  RATE  OR   ASYSTOLE   •  NOT  CLOSE  ENOUGH  TO  SCA  VICTIMS  (ONLY  7%  OF  SCA-­‐WERE  IN  4   MINUTE  DISTANCES  FROM  AEDs  LOCATED  IN  PUBLIC  PLACES).  
  6. 6. Current Solutions AED   •  MAINTENANCE    COST  IS   HIGH-­‐2363$/YEAR   •  AS  REPORTED  BY  ZOLL  
  7. 7. TED  Solu<on   Main  ideas   •  Use  the  AC  mains  as  source  of  energy   •  Shape  by  computer  the  sinusoidal  waveform-­‐to  a  similar   defibrilla<on  wave  as  that  of  a  standard  AED   •  Maximum  flexibility  in  future  waveform  genera<on                achieving  bener  results  with  less  Energy     •  Use  a  High  Voltage  Step  Up  Transformer                      
  8. 8. A Typical Monophasic Waveform Basic Output Waveform Classic Style 0 5 10 15 20 25 Time (msec) 30 35 40 45 50
  9. 9. TED  Solu<on   A  Typical    AC-­‐derived  Biphasic  Waveform   Basic Biphasic Output Waveform Classic Style 0 5 10 15 20 25 Time (msec) 30 35 40 45 50
  10. 10. TED  Solu<on   Advantages   •  Immediately  opera<onal   •  No  delay  in  repeated  opera<on  allowing:   –  Repeated  defibrilla<on  ,  no  need  to  recharge   –  Pacing  in  case  of  Cardiac  Stands<ll  or  Bradycardia     –  Pacing  override  for  VT  termina<on   •  No  Need  for  baneries  and  capacitor   •  Lower  cost  ,  more  reliable  than  AEDs              Therefore-­‐ideal  for  home-­‐use          
  11. 11. Leading to … •  Lower cost per unit •  Maintenance Free •  Reliable Therefore ideal for Use at Home Preferable to existing AEDs
  12. 12. Sudden  Cardiac  Arrest       The  market   •  It  should  be  recommended  by  physicians  to  pa<ents  at    increased  risk   of  SCA-­‐following  myocardial  infarc<on(MI),  hypertrophic  or  dilated   cardiomyopathy  or  gene<c  inclina<on  for  ventricular  arrhythmias   •  It  could  be  an  alterna<ve  treatment    for  pa<ents  who  are  candidates   for  surgically  implanted  defibrillator-­‐  AICDs:  poor  Leo  Ventricular   Func<on-­‐in  US  alone,  A.  Moss  es<mates  about  10  million  pts=200   billion  $-­‐NO  state  economy  can  afford  it!  Its  use  in  developing   countries-­‐limited   •  Pa<ents  post  MI,  or  at  risk  for  MI,  or  with  heart  failure   •  50%  of  men  and  63%  of  women  SCA  vic<ms  previously  reported  no   CHD  symptoms,-­‐it  may  afflict  anyone,  any<me...    
  13. 13. Sudden  Cardiac  Arrest   AICD   Automa<c  Internal   Cardiac  Defibrilla<on   (X20)     LVD   Leo  Ventricular     Dysfunc<on  (X10)       CHF   Conges<ve  Heart   Failure  (X8)     MI   Myocardial   Infarc<on  (X5)     The  market   TED  targets  by  risk  group       AICD   candidates   LVD-­‐CHF   Post  MI   Good  LV   High  risk  for  MI   Age>  40  
  14. 14. Sudden  Cardiac  Arrest   The  market   Ideally  a  personal  AED  should  be  present  in  every  home   exactly  like  fire  ex<nguishing  equipment.     Lower  Cost  will  lead  to  an  almost  unlimited  market.    
  15. 15. First  Animal  Study:  Defibrilla<on   5  small  pigs  (30-­‐40  Kg  body  weight)   General  anesthesia  with  ketamin  and  isofluoran   A  single  quadripolar  pacing  catheter  was  inserted  percutaneously   through  one  of  the  femoral  veins  or  jugular  vein   VF  was  induced  with  rapid  ventricular  burst  pacing  or  T  wave  shock   Defibrilla<on  of  stable  VF  aoer  15  seconds   If  failed  ,  immediate  rescue  shock  with  a  higher  energy  or  DC  shock   DFT  determined  with  AC  shock,  than  again  with  DC  shock  delivered   with  a  commercial  external  defibrillator  (Zoll)  using  a  step-­‐down   protocol   Comparison  of  DFT  between  modified  AC  and  standard  DC  shock    
  16. 16. First  Animal  Study:  Defibrilla<on   49  J  AC   Successful  Defibrilla<on  
  17. 17. Successful  Defibrilla<on   50 J DC
  18. 18. An Advanced Biphasic Waveform Advanced Biphasic Output Waveform 0 5 10 15 20 25 Time (msec) 30 35 40 45 50
  19. 19. Comparison  of  AC  and  DC  DFT  in  each   pig     a b
  20. 20. First  Animal  Study:  Defibrilla<on   DFT  with  MAC  versus  DC  Shocks  
  21. 21. First  Animal  Study:  Defibrilla<on   Rescue  Shock-­‐18  sec  aoer  first  shock  
  22. 22. Second  Animal  Study   •  •  •  •  •  •  Six  rats   Mean  weight  491.7±123.7  grams   mid  LAD  was  occluded  at  3  moths  age   3-­‐6  months  for  complete  recovery   MAC  defibrilla<on-­‐successful  in  all   External  pacing-­‐at  a  rate  above  sinus  rhythm-­‐ successful  in  all  
  23. 23. Second  Animal  Study:  External  pacing   Pacing   8  Volts  Threshold   Sinus  
  24. 24. Conclusions   •  Modified  AC  Shock  Defibrilla<on  is  feasible  and  as  effec<ve   as  the  standard  biphasic  DC  Defibrilla<on   •  Repeated  higher  energy  shocks  are  quickly  available   •  External  Pacing  is  feasible  and  durable    due  to  unlimited   energy   We  suggest  this  type  of  defibrilla<on  shock  to    be   implemented  in  Automa<c  External  Home  Defibrillators     This  low-­‐cost  new  technology  should  be  used  to  treat  sudden   cardiac  arrest  occurring  at  home/office  and  to  save  lives  
  25. 25. Publica<ons   Europace   Shimon  Rosenheck,  Shraga  Gorni,  Ioni   Katz,  Asaf  Rabin,  Uri  Shpoliansky,   Mendel  Mandelbaum,  and  Abraham   Teddy  Weiss  (2009)  Modified   alterna2ng  current  defibrilla2on:  a   new  defibrilla2on  technique,  Europace   11,  239–244.         Awards:   Neufeld  prize  for  the  best  paper  from   the  Israeli  Heart  Society  (2010)  
  26. 26. Thank  you  
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×