1. Heart Disease (Coronary Artery Disease) Slideshow Pictures
2. Medical Illustrations of the Heart Image Collection
3. Take the Heart Disease Quiz!

Medical Author:

Joseph Sciammarella, MD, FACP, FACEP

Joseph Sciammarella, MD, FACP, FACEP

Dr. Sciammarella graduated from American University of the Caribbean in June, 1985. He is a Diplomate of the American Board of Internal Medicine, and the American Board of Emergency Medicine and has practiced Emergency Medicine for 19 years.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Manual defibrillation, which is the traditional form of defibrillation performed by health care providers, is a complex skill.

• First, the operator must have the ability to interpret ECG (heart) rhythms.
  
  
• The operator also needs to be able to recognize which ECG abnormalities require defibrillation and which ones do not. (For example, a person with a "flat line" ECG would not require, or benefit from, defibrillation.)
  
  
• The operator needs to know how to manually operate the particular model of defibrillator that is available.

Originally, defibrillators were used only in hospitals.

• As the units became more portable, and as early EMS systems began to develop in the United States in the early 1970s, defibrillators began to be used outside the hospital by carefully trained and supervised paramedics.
  
  
• This was a significant step forward in increasing the chance of survival from out-of-hospital cardiac arrest. Rather than transporting the victim to a defibrillator, the defibrillator was transported to the victim.

Because of the delay inherent in getting an ambulance to the cardiac arrest victim within those critical first few minutes, many people continued to die from ventricular fibrillation.