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The evolution of medical technology and the heart

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Efforts to understand and cure heart problems stretch back centuries, with Leonardo da Vinci credited with one of the earliest discoveries related to coronary heart disease in the early 1500s. James Riches from defibshop, a UK-based independent supplier of automated external defibrillators, looks at some of the most important advances, from the early ECGs through to today’s wearable solutions

The Electrocardiogram

Otherwise known as an ECG or EKG, the electrocardiogram was invented by Dutch physiologist Willem Einthoven in 1903.

The first published electrocardiogram was actually in 1902, and was made using a string galvanometer. It was the first practical model that could be used on humans, and proved so successful that a year later he set about commercialising his creation.

Einthoven was subsequently cited in many further studies related to monitoring the heartbeat in humans. He was eventually awarded the Nobel prize in 1924. His invention, which you can see at the side of many hospital beds, saves countless lives every day by warning medical staff when a patient’s heart rate becomes abnormal.

These days wearable ECGs are freely available to anyone wishing to buy one. Frequently found in wristband form or as a pad attached to the chest area, they can be synced wirelessly with mobile devices to allow you to monitor your own heart rate on the fly. Thanks to the evolution of wearable tech, you can spot the danger signs as early as possible and keep your health in your own hands.

The Defibrillator

It’s easy to take defibrillators for granted in 2016. They are prominently displayed in both the workplace and public areas, with many organisations ensuring their staff are trained to use them in the event of an emergency. However, the most important advances in this area have only really happened in the last 60 years or so.

The earliest defibrillator is widely acknowledged to have been invented by the American surgeon Claude Beck in 1947. He had been carrying out experiments on animals by putting them into ventricular fibrillation and restarting their hearts, but was forced to up the ante somewhat when a young boy he was operating on went into cardiac arrest.

He attached two wooden-handled spoons to his device, which he had created to provide an electrical current that could be withstood by a human heart, and administered two shocks to the patient. The second was successful.

However, this was far from problem solved. Beck’s system could only be performed on an open chest and was far from consistent in keeping patients alive, Many survivors suffered broken ribs or further heart damage as a result of the treatment.

It wasn’t until 1956 that Paul Zoll devised a method of defibrillation that could be performed on a closed chest. It proved to be much more effective, in addition to requiring less time and removing the need to cut the patient open.

1978 proved to be a pivotal year in the science of defibrillation. This was the year that Automated External Defibrillators (AEDs) were invented. Before, defibrillation would have had to be carried out by a medical professional, but now the machine could do all the work for you. It came with detailed instructions that allowed anyone to learn how to use them and potentially save a cardiac arrest victim’s life while waiting for emergency medical help to arrive.

This is why you can now see these devices on the walls of public places. Again, your mobile device can come into play, with several apps available that will locate the nearest AED to you and indicate its whereabouts on a map.

Of course, defibrillators require someone to operate them, so it was only a matter of time before defibrillation branched out into the world of wearable tech. In 2001, inventors M. Stephen Heilman and Larry Bowling achieved FDA approval for their wearable cardioverter defibrillator, of LifeVest.

The product was created for those who are deemed to be at serious risk of a sudden cardiac arrest. With a victim’s survival chances known to diminish for every minute they go without some form of resuscitation, the LifeVest was designed to detect when the wearer registered an irregular heartbeat and administer a shock accordingly, even if the patient is asleep. The manufacturer claims that the product has a 98% success rate with its first shock.

In addition to wearable devices, advances in defibrillation have centred around adding more capabilities to existing AEDs, such as storing information about a patient’s heart rate to pass on to medical professionals, and regulations around where defibrillators must be present. Most businesses, for example, now recognise the importance of having these devices available.

The Artificial Heart

An artificial heart is primarily used for two purposes:

The heart-lung machine was first used successfully in 1953 by the surgeon John Gibbon. His patient was an 18-year-old woman, who was left on the machine for around 26 minutes while Gibbon repaired damage to the right side of her heart. She made a full recovery in under two weeks.

Dr Gibbon would, somewhat ironically, die from a heart attack in 1973. His work on cardiopulmonary bypass still forms a key part of many operations performed today.

The mechanical heart took a little longer to achieve success. An early prototype had to be tested on dogs as it was made from materials the human body would not have been able to support. However, by 1969 the first mechanical heart could be used on humans.

Unfortunately, this kind of success was all too rare for these early models, with survival rates of under two years. Users would also be confined to their hospital bed - it wasn’t until 1999 that the first patient could be sent home with an artificial heart.

In 2001, a group of surgeons in Kentucky were able to fully implant a mechanical heart into a patient for the first time, with no tubes or wires required, meaning the 24-year-old was able to go home and lead as normal a life as possible while a permanent transplant was found.

Whereas previous artificial hearts required a huge unit to support them, these newer models are lighter and can be worn in a backpack, allowing the wearer to get around more easily.

Of course, simulating a natural heartbeat is no easy task. Last year, a team from Rice University in Texas attempted to move one step closer to this by creating a leg brace designed to power an artificial heart.

The idea is that the wearer’s movements will power a motor than can provide energy to keep the artificial heart running, but the team are still looking to address issues such as comfort, weight and practicality.

This is an area that is progressing even as we speak, as scientists continue to look at ways to keep heart patients from being confined to a hospital bed.

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