7 ms·

Defibrillation devices save lives using 1k times less electricity

114 points by wglb 2y ago

echoangle 2y ago
> Energy reduction in defibrillation devices is an active area of research. While defibrillators are often successful at ending dangerous arrhythmias in patients, they are painful and cause damage to the cardiac tissue. I thought this was about needing a smaller battery in defibrillators and was wondering if that is really a problem, but this makes more sense.
- duskwuff 2y ago
  This is more about implanted defibrillators than AEDs. In implanted devices, the size of the battery absolutely does matter.
walrushunter 2y ago
[flagged]
- Groxx 2y ago
  Than other defibrillation devices, is my default interpretation, because I know they use electricity and there are no other subjects in the sentence. So: reading comprehension and common knowledge.
  - meroes 2y ago
    Well you got it wrong since there are no "other defibrillation devices" since these are computer models.
- deleted 2y ago
  [deleted]
- addy34 2y ago
  Less than low energy antitachycardia pacing (LEAP), which is itself a lower-energy alternative to the typical 1-shock defibrillation. Their "1000 times less" means three orders of magnitude. From the abstract of the paper: We find that, rather counter-intuitively, a single, properly timed, biphasic pulse can be more effective in defibrillating the tissue than low energy antitachycardia pacing (LEAP), which employs a sequence of such pulses, succeeding where the latter approach fails. Furthermore, we show that, with the help of adjoint optimization, it is possible to reduce the energy required for defibrillation even further, making it three orders of magnitude lower than that required by LEAP Important to note that the study uses: "an electrophysiological computer model of the heart's electrical circuits " and "a simple two-dimensional model of cardiac tissue"
- YeahThisIsMe 2y ago
  I assume it means 1/1000th because the phrase makes zero sense.
- BurningFrog 2y ago
  Seeing this phrasing more and more, and I don't like it. "...using 0.1% as much electricity" feels far more proper.
- poincaredisk 2y ago
  Why the harsh words and insults? I understand the headline immediately, so as a smart person you probably did too. Though this phrase has a literal translation to my native language. Maybe the person who wrote this is not a native speaker? But definitely not illiterate, come on.
Groxx 2y ago
>[in an] electrophysiological computer model Worth researching perhaps, lower power is much safer for a lot of other parts of the body, but is there reason to believe that this is correct? Are these models really that good?
Hilift 2y ago
This is actually interesting for multiple reasons. One is the technology. The other is the positive outcome rate for cardiac arrest after 30 days is so low. The percentage of cardiac arrest survivors with positive outcomes 30 days after release depends on the type of cardiac arrest, and can range from 40% to 82%: In-hospital cardiac arrest (IHCA) The 30-day survival rate for IHCA is around 25% in the United States and up to 35% in European countries. *In one study, the 30-day survival rate was 40%, with 34% of survivors having good neurological outcomes*. Out-of-hospital cardiac arrest (OHCA) The probability of survival after OHCA can be increased by providing immediate cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED). In one study, *10% of people who experienced OHCA survived with a favorable neurological outcome*. https://pmc.ncbi.nlm.nih.gov/articles/PMC8359113/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8359113/
- Ylpertnodi 2y ago
  [flagged]
  - adrianN 2y ago
    There are too many variables involved in these outcomes to make such a comment.
- dukeofdoom 2y ago
  My father survived this. No brain damage. Lived a few more years, until 74. The heart wasn't pumping at normal rates because of damage. Do to hip problems (arthritis) also had problems walking. Eventually Developed a blood clot in a leg. Initially survived the blood clot. But the medication given to thin out the blood clot caused bleeding on his liver. Somehow the Hospital missed the bleeding until it was too late. The operating room was also busy (Canada), so no intervention could be performed. Wasn't allowed to see him because of covid rules. Possibly been able to advocate for him if I was in his room, and saw his worsening condition. They can save your life in a hospital, but just as easily kill you by mistake or side effect of whatever intervention they are doing. Also, walking (or being able to walk) is very important for longevity. But the speed of the first response of the cardiac arrest is what matters. Since the brain is without oxygen. Assuming the person makes it to a hospital alive, they'll cool off the body to prevent brain damage. For every minute you survive, your odds get better.
softgrow 2y ago
The article is about internal defibrillators. External ones are still the same as (good grief) 35 years ago (well maybe down from 300J to 200J). The only change I've noticed is moving from a gel for the pads to a gel pad (which feel like a frog, chuck one in your partners bed and let them find it!) which reduced the possibility of burning and odd smells in your ambulance. Fortunately my sense of smell wasn't great and often had a partner who smoked (and was allowed to in the olden days) in the ambulance to dull it. You kids don't know how it was having to actually manually read the trace instead of all this new-fangled automation that guides you through it.
- breezeTrowel 2y ago
  I think the biggest change with external defibrillators has been placement. It's now front and back instead of two on the front.
  - wbl 2y ago
    I should redo my CPR then. Learned two on the front in high school in NJ. But also to read the instructions though I'm sure when seconds count you don't.
    - AndrewDavis 2y ago
      Modern AEDs have voice guidance telling the person what to do. So you can follow the instructions as you do it. Also, you should call the emergency number in your region and (at least in Australia) they'll transfer you to someone who can coach you through using the defib and performing CPR until professional help arrives. Don't let that stop anyone from getting their CPR up to date though. The more experience you have the better equipped you'll be if you need to use it
      - giantg2 2y ago
        I see AEDs at work. If I have a heart attack, I have no confidence in my team being able to use it. I've seen how they handle requirements and documentation in stories.
snapetom 2y ago
They’re already commercializing this. I’m due for a new implanted defibrillator because of a needed battery change. My current one is 5in x 4in. Depending on when I get it, my electrophysiologist says next one should be smaller due to a smaller required charge to jump start the heart.
- KineticLensman 2y ago
  > They’re already commercializing this. My ICD is an Abbott Ellipse VR [0] and is 2 x 2.5 x 0.5 inches in size. It doesn't make too much of a bump under my skin. It was implanted in 2021 and I don't think was new then. [0] https://www.cardiovascular.abbott/int/en/hcp/products/cardiac-rhythm-management/implantable-cardioverter-defibrillators/ellipse.html https://www.cardiovascular.abbott/int/en/hcp/products/cardia...
  - snapetom 2y ago
    Oh, interesting. I haven't looked it up, but I'm probably getting another Boston Scientific. Mine was implanted in 2018.
- KineticLensman 2y ago
  [Edit] > They’re already commercializing this. Sorry to disappoint, and unfortunately, no. See other comments elsewhere. This study is based on a theoretical study of 2D simulated tissues. The original paper itself contains the disclaimer... >> "The approach considered here is impractical – it requires an accurate mathematical model of the tissue as well as complete knowledge of the state of the tissue at the initial time. Furthermore, computation of a defibrillating electrical field cannot be performed in real time."
  - snapetom 2y ago
    For this study, yes, but the trend of less and less charges has been occurring for a few years. There have been numerous studies that have happened 3-4 years ago that's even in the cituations.
niemandhier 2y ago
This appears to be a simulation study done in 2d. Similar results have been observed in 2d simulations for more than 20 years, no one had managed to translate them to application. One of the problems is, that 2 d and 3d reaction-diffusion systems are very different when it comes to so-called topological charge conservation. One can show that interactions of the applied electrical field can be described by its influence on the topological charges. In 2d these topological charges are limited to points in 3d they form curves. Points are limited to drifting and colliding, lines can twist, self collide, form rings and so on making translating 1d results to 3d quite difficult.
- KineticLensman 2y ago
  > This appears to be a simulation study done in 2d. Yes. The paper says >> In this study, a simple two-dimensional numerical model of atrial tissue containing anatomical heterogeneities – the essential ingredient responsible for the emergence of virtual electrodes – was used to explore ultra-low-energy defibrillation. > no one had managed to translate them to application. Yes. The paper itself has the following statements in its conclusion: >> The approach considered here is impractical – it requires an accurate mathematical model of the tissue as well as complete knowledge of the state of the tissue at the initial time. Furthermore, computation of a defibrillating electrical field cannot be performed in real time.
nyanpasu64 2y ago
I remember playing with spiral waves using the VIRUS element in Powder Game (2), and didn't know that heartbeat disturbances were caused by the same patterns on cardiac muscle.
- wizzwizz4 2y ago
  Powder Game: https://dan-ball.jp/en/javagame/dust/ https://dan-ball.jp/en/javagame/dust/ Powder Game 2: https://dan-ball.jp/en/javagame/dust2/ https://dan-ball.jp/en/javagame/dust2/ Emoji Simulator: https://ncase.me/sim/?s=bz https://ncase.me/sim/?s=bz
  - Doxin 2y ago
    The Powder Toy: https://powdertoy.co.uk/ https://powdertoy.co.uk/
yapyap 2y ago
1k times, really?
kleiba 2y ago
The original article has the number 1,000 in its title, why the ridiculous change to 1k for hackernews? As a matter of fact, as it is written right now, it makes little sense compared to the article's actual headline.
Nifty3929 2y ago
You mean 99.9% less, or 1/1000th as much, or 0.1% as much.

114 points by wglb 2y ago

> Energy reduction in defibrillation devices is an active area of research. While defibrillators are often successful at ending dangerous arrhythmias in patients, they are painful and cause damage to the cardiac tissue. I thought this was about needing a smaller battery in defibrillators and was wondering if that is really a problem, but this makes more sense.

duskwuff 2y ago
This is more about implanted defibrillators than AEDs. In implanted devices, the size of the battery absolutely does matter.

walrushunter 2y ago

[flagged]

Groxx 2y ago
Than other defibrillation devices, is my default interpretation, because I know they use electricity and there are no other subjects in the sentence. So: reading comprehension and common knowledge.
- meroes 2y ago
  Well you got it wrong since there are no "other defibrillation devices" since these are computer models.
deleted 2y ago
[deleted]
addy34 2y ago
Less than low energy antitachycardia pacing (LEAP), which is itself a lower-energy alternative to the typical 1-shock defibrillation. Their "1000 times less" means three orders of magnitude. From the abstract of the paper: We find that, rather counter-intuitively, a single, properly timed, biphasic pulse can be more effective in defibrillating the tissue than low energy antitachycardia pacing (LEAP), which employs a sequence of such pulses, succeeding where the latter approach fails. Furthermore, we show that, with the help of adjoint optimization, it is possible to reduce the energy required for defibrillation even further, making it three orders of magnitude lower than that required by LEAP Important to note that the study uses: "an electrophysiological computer model of the heart's electrical circuits " and "a simple two-dimensional model of cardiac tissue"
YeahThisIsMe 2y ago
I assume it means 1/1000th because the phrase makes zero sense.
BurningFrog 2y ago
Seeing this phrasing more and more, and I don't like it. "...using 0.1% as much electricity" feels far more proper.
poincaredisk 2y ago
Why the harsh words and insults? I understand the headline immediately, so as a smart person you probably did too. Though this phrase has a literal translation to my native language. Maybe the person who wrote this is not a native speaker? But definitely not illiterate, come on.

Groxx 2y ago

>[in an] electrophysiological computer model Worth researching perhaps, lower power is much safer for a lot of other parts of the body, but is there reason to believe that this is correct? Are these models really that good?

Hilift 2y ago

This is actually interesting for multiple reasons. One is the technology. The other is the positive outcome rate for cardiac arrest after 30 days is so low. The percentage of cardiac arrest survivors with positive outcomes 30 days after release depends on the type of cardiac arrest, and can range from 40% to 82%: In-hospital cardiac arrest (IHCA) The 30-day survival rate for IHCA is around 25% in the United States and up to 35% in European countries. *In one study, the 30-day survival rate was 40%, with 34% of survivors having good neurological outcomes*. Out-of-hospital cardiac arrest (OHCA) The probability of survival after OHCA can be increased by providing immediate cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED). In one study, *10% of people who experienced OHCA survived with a favorable neurological outcome*. https://pmc.ncbi.nlm.nih.gov/articles/PMC8359113/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8359113/

Ylpertnodi 2y ago
[flagged]
- adrianN 2y ago
  There are too many variables involved in these outcomes to make such a comment.
dukeofdoom 2y ago
My father survived this. No brain damage. Lived a few more years, until 74. The heart wasn't pumping at normal rates because of damage. Do to hip problems (arthritis) also had problems walking. Eventually Developed a blood clot in a leg. Initially survived the blood clot. But the medication given to thin out the blood clot caused bleeding on his liver. Somehow the Hospital missed the bleeding until it was too late. The operating room was also busy (Canada), so no intervention could be performed. Wasn't allowed to see him because of covid rules. Possibly been able to advocate for him if I was in his room, and saw his worsening condition. They can save your life in a hospital, but just as easily kill you by mistake or side effect of whatever intervention they are doing. Also, walking (or being able to walk) is very important for longevity. But the speed of the first response of the cardiac arrest is what matters. Since the brain is without oxygen. Assuming the person makes it to a hospital alive, they'll cool off the body to prevent brain damage. For every minute you survive, your odds get better.

softgrow 2y ago

The article is about internal defibrillators. External ones are still the same as (good grief) 35 years ago (well maybe down from 300J to 200J). The only change I've noticed is moving from a gel for the pads to a gel pad (which feel like a frog, chuck one in your partners bed and let them find it!) which reduced the possibility of burning and odd smells in your ambulance. Fortunately my sense of smell wasn't great and often had a partner who smoked (and was allowed to in the olden days) in the ambulance to dull it. You kids don't know how it was having to actually manually read the trace instead of all this new-fangled automation that guides you through it.

breezeTrowel 2y ago
I think the biggest change with external defibrillators has been placement. It's now front and back instead of two on the front.
- wbl 2y ago
  I should redo my CPR then. Learned two on the front in high school in NJ. But also to read the instructions though I'm sure when seconds count you don't.
  - AndrewDavis 2y ago
    Modern AEDs have voice guidance telling the person what to do. So you can follow the instructions as you do it. Also, you should call the emergency number in your region and (at least in Australia) they'll transfer you to someone who can coach you through using the defib and performing CPR until professional help arrives. Don't let that stop anyone from getting their CPR up to date though. The more experience you have the better equipped you'll be if you need to use it
    - giantg2 2y ago
      I see AEDs at work. If I have a heart attack, I have no confidence in my team being able to use it. I've seen how they handle requirements and documentation in stories.

snapetom 2y ago

They’re already commercializing this. I’m due for a new implanted defibrillator because of a needed battery change. My current one is 5in x 4in. Depending on when I get it, my electrophysiologist says next one should be smaller due to a smaller required charge to jump start the heart.

KineticLensman 2y ago
> They’re already commercializing this. My ICD is an Abbott Ellipse VR [0] and is 2 x 2.5 x 0.5 inches in size. It doesn't make too much of a bump under my skin. It was implanted in 2021 and I don't think was new then. [0] https://www.cardiovascular.abbott/int/en/hcp/products/cardiac-rhythm-management/implantable-cardioverter-defibrillators/ellipse.html https://www.cardiovascular.abbott/int/en/hcp/products/cardia...
- snapetom 2y ago
  Oh, interesting. I haven't looked it up, but I'm probably getting another Boston Scientific. Mine was implanted in 2018.
KineticLensman 2y ago
[Edit] > They’re already commercializing this. Sorry to disappoint, and unfortunately, no. See other comments elsewhere. This study is based on a theoretical study of 2D simulated tissues. The original paper itself contains the disclaimer... >> "The approach considered here is impractical – it requires an accurate mathematical model of the tissue as well as complete knowledge of the state of the tissue at the initial time. Furthermore, computation of a defibrillating electrical field cannot be performed in real time."
- snapetom 2y ago
  For this study, yes, but the trend of less and less charges has been occurring for a few years. There have been numerous studies that have happened 3-4 years ago that's even in the cituations.

niemandhier 2y ago

This appears to be a simulation study done in 2d. Similar results have been observed in 2d simulations for more than 20 years, no one had managed to translate them to application. One of the problems is, that 2 d and 3d reaction-diffusion systems are very different when it comes to so-called topological charge conservation. One can show that interactions of the applied electrical field can be described by its influence on the topological charges. In 2d these topological charges are limited to points in 3d they form curves. Points are limited to drifting and colliding, lines can twist, self collide, form rings and so on making translating 1d results to 3d quite difficult.

KineticLensman 2y ago
> This appears to be a simulation study done in 2d. Yes. The paper says >> In this study, a simple two-dimensional numerical model of atrial tissue containing anatomical heterogeneities – the essential ingredient responsible for the emergence of virtual electrodes – was used to explore ultra-low-energy defibrillation. > no one had managed to translate them to application. Yes. The paper itself has the following statements in its conclusion: >> The approach considered here is impractical – it requires an accurate mathematical model of the tissue as well as complete knowledge of the state of the tissue at the initial time. Furthermore, computation of a defibrillating electrical field cannot be performed in real time.

nyanpasu64 2y ago

I remember playing with spiral waves using the VIRUS element in Powder Game (2), and didn't know that heartbeat disturbances were caused by the same patterns on cardiac muscle.

wizzwizz4 2y ago
Powder Game: https://dan-ball.jp/en/javagame/dust/ https://dan-ball.jp/en/javagame/dust/ Powder Game 2: https://dan-ball.jp/en/javagame/dust2/ https://dan-ball.jp/en/javagame/dust2/ Emoji Simulator: https://ncase.me/sim/?s=bz https://ncase.me/sim/?s=bz
- Doxin 2y ago
  The Powder Toy: https://powdertoy.co.uk/ https://powdertoy.co.uk/

yapyap 2y ago

1k times, really?

kleiba 2y ago

The original article has the number 1,000 in its title, why the ridiculous change to 1k for hackernews? As a matter of fact, as it is written right now, it makes little sense compared to the article's actual headline.

Nifty3929 2y ago

You mean 99.9% less, or 1/1000th as much, or 0.1% as much.