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
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TED External Home Defibrillator for Home Consumer innovation
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. 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. 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. Current
Solu<ons
AICD
•
•
•
•
•
•
VERY
HIGH
COST
(20,000$)
NEEDS
OPERATIVE
PROCEDURE
(RISKY)
MAY
DELIVER
INAPROPRIATE
SHOCKS
NEEDS
CARE
AND
REPLACEMENT
PSYCHOLOGIC
BURDEN
END-‐OF-‐LIFE
PROBLEMS
5. Current
Solu<ons
AEDs-‐
in
public
places
•
HIGH
COST
PER
UNIT
(1000-‐2000$)
•
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).
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
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. Leading to …
• Lower cost per unit
• Maintenance Free
• Reliable
Therefore ideal for Use at Home
Preferable to existing AEDs
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. 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. 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. 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
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
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. 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)