Defibrillator

The defibrillator emerged because cardiac surgeons understood that ventricular fibrillation—the chaotic electrical storm that stops effective heartbeats—could theoretically be reset by a stronger electrical jolt. The challenge was translating animal experiments to human application without killing the patient.

Claude S. Beck (1894-1971) pioneered heart surgery at University Hospitals in Cleveland, developing operations to improve circulation in damaged hearts. He also investigated cardiac resuscitation, recognizing that fibrillation was often survivable if corrected quickly. Beck's device was remarkably simple: a transformer to isolate the patient from 110-volt wall current, a variable resistor to limit current to heart-safe levels, and two metal tablespoons with wooden handles to deliver the shock to exposed cardiac tissue. The device was built by James H. Rand III in 1947.

On August 29, 1947, Beck performed the first successful human defibrillation. The patient was Richard Heyard, a 14-year-old boy undergoing surgery for pectus excavatum (a congenital chest deformity). Near the end of the procedure, his heart entered ventricular fibrillation. Manual cardiac massage failed. With the chest already open, Beck connected electrodes directly to Heyard's heart and delivered four shocks at 110 volts. The heart resumed normal rhythm. Heyard survived.

But open-chest defibrillation required surgery already in progress. The next breakthrough came from Harvard cardiologist Paul Zoll, who convinced Electrodyne to build an external defibrillator—a bulky, wheeled machine that converted 120-volt wall power to 720 volts delivered through electrodes on the chest wall. In 1956, Zoll reported four patients successfully reversed from ventricular fibrillation to normal rhythm without opening the chest.

These early defibrillators weighed 120 kilograms and remained confined to hospitals. The portable defibrillator came from Frank Pantridge in Belfast in the mid-1960s. His first mobile version weighed over 150 pounds and ran on car batteries. By decade's end, Pantridge had reduced the weight to just six pounds—enabling the emergency cardiac care that has since saved millions of lives.

Beck's tablespoon electrodes began a cascade from operating room to hospital ward to ambulance to airports and offices, each step expanding who could be saved from sudden cardiac death.