Defibrillators Who Needs a Defibrillator?

An AED can save the life of someone in cardiac arrest, when the heart suddenly and unexpectedly stops beating.

Your healthcare provider will order heart tests to determine whether you need an ICD or WCD. Genetic testing and your family’s health history may show you have a higher risk of developing dangerous arrhythmias that could lead to cardiac arrest. Some persons with reduced ejection fraction heart failure or who have a high risk of life-threatening arrhythmias, as well as survivors of cardiac arrest, may be advised to get an ICD or WCD.

Defibrillators can be used for babies, children, teens, and adults. Your provider may recommend a transvenous (through a vein) or subcutaneous (under the skin) ICD to treat an arrhythmia and prevent new or repeat cardiac arrest. CRT-Ds may help people who have severe heart failure and certain types of arrhythmias.

WCDs can help protect people who have a high short-term risk of cardiac arrest.

Review the types of defibrillators and how they work.

Using an AED to Save a Life

Calling 9-1-1 and immediately treating with CPR (cardiopulmonary resuscitation) and defibrillation can save the life of a person in cardiac arrest. You don’t need special training to respond in an emergency. AEDs provide step-by-step printed and audio instructions.

Fast action saves lives

Most people who have a cardiac arrest do not receive treatment quickly enough to survive. A person whose heart stops must get help within 10 minutes. By giving CPR to someone in cardiac arrest, you can double or triple their chance of survival.

It is likely that a person is having a cardiac arrest if they:

Collapse suddenly and lose consciousness (pass out)
Stop breathing, don’t breathe effectively, or start gasping for air
Do not respond to shouting, tapping, or gentle shaking. However, never shake an infant or young child. Learn more about how to check a child’s response.
Do not have a pulse. It’s hard to find a pulse, so you do not need to spend time trying to check it. Instead, call 9-1-1, start CPR, and get an AED.

How to use an AED

If you think someone is in cardiac arrest, take the following steps:

Call 9-1-1 or tell someone else to call 9-1-1. A person has a better chance of surviving if first responders arrive quickly, so calling 9-1-1 first is very important. If two rescuers are present, one can give CPR while the other calls 9-1-1 and gets the AED.
Start CPR right away. Learn more about doing “hands-only” CPR. It isn’t necessary to breathe into the person’s mouth.
Locate an AED or send another person to get it. If no AED is available, continue CPR until help arrives.
Remove clothing from the person’s chest. AEDs include scissors to cut clothes, including a bra, if necessary to apply the electrode pads.
Use the AED by following the instructions the machine provides.
Make sure the area around the person is clear. Touching the person could interfere with the AED’s reading of the person’s heart.
Listen for voice prompts that tell you when and how to give an electric shock, if one is needed, to restore a normal rhythm. Electrodes deliver the shock, and some deliver more than one shock.
Start CPR again after delivering the shock if the device instructs you to do so.
Continue CPR until first responders or a person trained in CPR arrives.

Be prepared for emergencies

Everyone can help recognize the symptoms of cardiac arrest and take action if they see someone having an arrest. Important steps include calling 9-1-1 first, performing CPR, and using an AED. Ask another person to call 9-1-1 and locate an AED while you start CPR.

Know where to find AEDs. AEDs are in many public places, including offices, schools, shopping malls, grocery stores, airports, event venues, and gyms. Check to see whether your office, gym, or school has an AED.
Learn how to use an AED. AEDs are not hard to use, but training is very helpful. AED training is often provided along with CPR training. Many major health organizations offer classes. Some training is available online. Find a basic life support class near you.
Take action to increase public access to AEDs. You can suggest installing AEDs in the places people gather and work in your community. Be alert when you travel, as AEDs can save lives on ships, trains, and aircraft, where first responders may not be available right away.

Treating a child with an AED

AEDs include a set of smaller electrode pads for children who are under 8 years old or weigh less than 55 pounds. If no small pads are available, use the adult-sized pads. Follow the AED’s instructions.

Who can benefit from an ICD?

Your healthcare provider may recommend an ICD if you have a condition that raises your risk for a dangerous arrhythmia or cardiac arrest.

Your provider detected certain types of arrhythmias during an electrocardiogram (EKG) or stress test.
You survived a cardiac arrest.
You have a genetic condition that causes arrhythmia. This includes having congenital heart disease or a conduction disorder.
You developed an arrhythmia during or after treatment for a heart attack.
You have a neuromuscular disorder. For example, muscular dystrophy can damage the heart and cause unpredictable heart rhythms.
You have an abnormally slow heart rate or another problem with the heart’s electrical signals.
You have cardiac sarcoidosis.
You have poor heart function following a procedure such as coronary artery bypass grafting.

Your healthcare provider may recommend a subcutaneous ICD (SICD) if you have a high risk of cardiac arrest and you:

Do not need a pacemaker function
Are younger, so you are likely to have a long life expectancy (live a long time)
Have a high risk for infection
Had a transvenous ICD that was removed because of an infection.

Read some tips for women who need an SICD.

Everyone at high risk for CA or life-threatening arrhythmia can benefit from ICDs.

ICDs can prevent death from dangerous arrhythmias. However, studies suggest that some people, such as women and people of color, are less likely to get an ICD even if they have a high risk of cardiac arrest. More studies are needed to help healthcare providers understand how these groups can benefit from ICDs. Scientists are finding ways to remind healthcare providers about the benefits of ICDs, and studies are exploring how bias and other issues may cause gaps in care.

CRTD-s can give high-energy shocks and pacing therapy. They have an extra lead to help sync the pumping action of both ventricle . Healthcare providers may recommend CRT-Ds for people who have a high risk for cardiac arrest and other conditions such as:

Advanced heart failure
Atrioventricular block
Other conditions that require pacing of both ventricles (biventricular pacing)

Who can benefit from a WCD?

Healthcare providers may recommend WCDs for people who have a short-term high risk for cardiac arrest. This includes people who are recovering from a heart attack or a heart procedure, waiting for surgery for an ICD or a heart transplant, recovering from myocarditis (heart inflammation), or starting treatment for severe cardiomyopathy.

WCDs are approved for adults and for children who weigh at least 41 pounds and whose chest measures at least 26 inches around – about the chest size of an 8-year-old.

WCDs can be lifesaving, but they have some disadvantages that some people find hard to manage. For example:

You can’t wear a WCD while bathing, showering, or swimming.
A WCD needs frequent battery charges.
There’s a risk that someone in close physical contact with you could get hurt if the vest sends a shock to your heart.

How long can you use a WCD?

Usually, healthcare providers recommend WCDs for people who have a short-term high risk for dangerous arrhythmias. While most people use a WCD for a few weeks or months, they can be used for a longer time by people who aren’t eligible for an ICD or who don’t want one.