Published on March 8, 2014
TED-‐Time and life-‐saving External Deﬁbrillator: a Home AED Inventors and patent holders: Prof. A. Teddy Weiss & team at Hadassah Hospital, Jerusalem, Israel firstname.lastname@example.org
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.
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
Current Solu<ons AICD • • • • • • VERY HIGH COST (20,000$) NEEDS OPERATIVE PROCEDURE (RISKY) MAY DELIVER INAPROPRIATE SHOCKS NEEDS CARE AND REPLACEMENT PSYCHOLOGIC BURDEN END-‐OF-‐LIFE PROBLEMS
Current Solu<ons AEDs-‐ in public places • HIGH COST PER UNIT (1000-‐2000$) • 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).
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 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
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 Style 0 5 10 15 20 25 Time (msec) 30 35 40 45 50
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
Leading to … • Lower cost per unit • Maintenance Free • Reliable Therefore ideal for Use at Home Preferable to existing AEDs
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...
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
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.
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
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 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
Second Animal Study: External pacing Pacing 8 Volts Threshold Sinus
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
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)
Calcification Inhibitors in CKD and Dialysis Patients
Low Cost Home External Defibrillator Innovation - TED ... The low cost manufacturing price will enable home consumers to purchase it and save ...
AEDs — Automatic External Defibrillators — are designed for ... We developed TED, ... Home; Low-cost; Home consumer; Sudden cardiac death (SCD ...
LinkedIn Home What is LinkedIn? Join Today Sign In Main content starts below. ... Defibrillator at a glance: 21,147 LinkedIn members have this skill.
Next Article > June 2014Volume 15, Issue 4, Pages 233–234
TED is a nonprofit devoted to Ideas Worth Spreading ... corals and other sea creatures can call home. We humans This is how our bodies betray us in a lie
Philips HeartStart Home Defibrillator with Life Guidance ... Innovation. Our innovation story. Research & Exploration. Thought Leadership. HealthSuite ...
Home: AED Pads & Batteries: ... of Automated External Defibrillators ... and reliable emergency medical products at reduced costs to the consumer.
Innovation for Supply ... and management of external carriers or ... TED External Home Defibrillator for Home Consumer innovation ...