History Matters Friday, March 24, 2023
A shocking history
In 1768 in Amsterdam, there arose groups called “rescue societies” to try and resuscitate the dying. They used an electrical device called the “Leyden jar” to try and “re-animate” the person. These groups spread throughout Europe and in 1774, the Royal Humane Society for the Apparently Dead (which sounds like a Monty Python skit) was the first to successfully shock a child back to life (and probably the first report of childhood obstructive sleep apnea…as well as pediatric PTSD!)
The earliest battery by Volta and Galvani in 1799 led to the invention of an electric chair for resuscitation called the “reanimation chair”. Galvani’s nephew, Giovanni Aldini, showed that a newly executed prisoner placed in a “re-animation chair” sometimes actually sat up and opened their eyes. This was a widely circulated story among the lay public.
Leading researchers in electricity included Humphrey Davy and William Nicholson who would go over to their friend’s house , Mr. Shelly, and discuss such possibilities as “re-animation”. There was a little girl in the house, Mr. Shelly’s daughter, Mary Shelley who listened carefully to such stories. She would later produce a wildly popular play, Frankenstein, (where a man is “re-animated” with a criminal brain) in 1823.
The idea that the human body itself was “electrical” and that each heart beat created an electrical impulse was put forth by Carlo Matteucci. In 1895, Dutch physician, William Einthoven showed that these electrical impulses from the heart could be graphed as an electro-cardio graph (ECG).
Ventricular fibrillation as a cause of sudden death would not be recognized until the 1920’s when the Edison Company offered a $10,000 reward to solve the problem of company linemen dying while installing electrical circuits. In 1957, Dr. Charles Beck performed the first open thoracotomy defibrillation using two spoons and a defibrillation device he had been experimenting with in his lab. He was a controversial surgeon, and in 1963 initiated teaching the lay public principles of resuscitation which were not adopted until 1973 by the American Heart Association.
In 1959, Russian engineers , Drs. V. Eskin and A. Klimov pioneered an external defibrillator. It weighed 280 pounds (trimmed down to 50 pounds by 1963). While pre-hospital portable defibrillation had been discussed, this idea got a huge boost in 1972 when former President Lyndon Johnson was defibrillated following an acute MI.
The first FDA approved implantable defibrillator was used in 1985 by pioneers Dr. C. Walton Lillehei and Earl Bakken when Dr. Lillehei had found out that one of his patients had died because there was no accessible defibrillator. And the concept of public access to defibrillation was later funded by Congress in 2002. Whether having universal teaching of defibrillation and using AEDs everywhere is cost effective, or even clinically effective in the majority of situations is highly debatable, but there is no question of its value in the initial few minutes of a witnessed cardiac arrest. After 230 years of re-animating the “apparently dead”, we are at a place where success, especially with implantable defibrillators, is nothing short of shocking!
REFERENCES
The Pharos Spring 2005: 17-22.