The First Successful External Cardiac Stimulation and A-C Defibrillation

In 1948, I became interested in cardiac resuscitation because of a patient with Stokes-Adams disease who died in the hospital despite all the authors' best efforts, and I set out to stimulate the heart externally by applying large electrical currents across the unopened chest—just as small currents would suffice when applied directly to the myocardium.

Abstract

In 1948, I became interested in cardiac resuscitation because of a patient with Stokes-Adams disease who died in the hospital despite all our best efforts. Her idioventricular rhythm just slowed progressively; then it stopped intermittently producing dreadful Stokes-Adams attacks, and she died. I remembered then that Claude Beck talked about "hearts that were too good to die" Her heart was capable of contracting but it just didn't beat reliably and quickly enough. It had been known since 1880 that the heart could be stimulated by an electrical current in direct application, but no clinical use had been made of this information. I set out to stimulate the heart externally, simply by applying large electrical currents across the unopened chest—just as small currents would suffice when applied directly to the myocardium. I started with one electrode in the esophagus since it lay behind the heart near the ventricles.