It began with a chance encounter and evolved into a feat of engineering that has been described as a technical marvel. The story of the defibrillator from its early days to modern times is one of perseverance and innovation, involving many talented individuals. Here, you can follow the journey for yourself.

Laying the Foundations

By the late 1800s, electricity was being embraced by Western society in a variety of new ways. Thomas Edison’s incandescent light bulb had been unveiled and he had pioneered the construction of the first central power station. Meanwhile, Nikola Tesla had discovered how to harness alternating current (AC) power, opening the door for many exciting practical applications.

At around the same time, experts were making progress with their understanding of sudden cardiac death (SCD). In 1889, scientist John McWilliam published a paper suggesting that ventricular fibrillation was the leading mechanism behind SCD. A decade later, in 1899, physiologists Jean-Louis Prévost and Frédéric Batelli revealed that weak electrical shocks could bring about ventricular fibrillation in animals and, crucially, that a further shock could reverse this. The significance of these findings for emergency medicine would be revealed over time. This was helped along by the work of electrical engineer William Kouwenhoven and his colleagues, from the late 1920s onwards, who were able to confirm and build on the initial findings.

The first example of defibrillation in humans came about by chance. In 1947, while cardiac surgeon Claude Beck was operating on a 14-year-old patient, the patient’s heart stopped. At the time, Beck had been doing his own experiments with ventricular fibrillation in animals. So, he called for his equipment to be brought to him and he performed open-chest defibrillation on his patient. It worked, and it paved the way for others to follow his lead.

The Early Days

In the wake of Beck’s success, open-chest defibrillation began to be used in other hospitals. Questions arose over where the technology could go next. Was it possible to create an external transthoracic defibrillator – a device that could be used without opening up a patient’s chest? Could such external defibrillation be performed effectively and safely? Around the world, experts were looking for answers, and the results were encouraging. Their work included the following innovations:

  • In 1952, the world’s first commercially available transthoracic direct current (DC) defibrillator was produced, designed by Naum Gurvich, a physician in the Soviet Union.
  • In 1956, American cardiologist Paul Zoll successfully used a transthoracic AC defibrillator, which he had designed.
  • In 1957, Kouwenhoven and his team in the US unveiled their own version of a transthoracic AC defibrillator.
  • Also in 1957, a more compact and portable DC defibrillator was produced by manufacturing company Prema. The device was designed by Bohumil Peleška, a physician from Czechoslovakia, who built on the ideas of Gurvich.
  • In 1962, American cardiologist Bernard Lown and colleagues reported the successful use of single DC monophasic shocks in multiple patients, paving the way for a ‘new method’ in Western hospitals.
  • In 1965, UK-based cardiologist Frank Pantridge – known as the ‘Father of Emergency Medicine’ – worked with a colleague, John Geddes, to invent a defibrillator that could be installed in an ambulance.

Impressive progress had been made. However, despite improvements over time, the out-of-hospital defibrillators of the late 1960s and early 1970s were still not portable in the way we understand it today. Their weight (which could be 20kg or more) and power-needs were significant limitations.

The Modern Devices

How was it possible to go from the heavy, power-hungry defibrillators of the early days to devices that were truly portable? And how could these devices be made safe for civilians to use? A number of changes were needed. These included replacing the heavy paddles that were characteristic of the early devices with adhesive patches. This led to the defibrillators being lighter and using less energy. It also meant that only one person was needed to operate a device. Another design change involved switching the defibrillators from a monophasic waveform to a biphasic one. As well as being more effective, this decreased the power needed for the devices to perform defibrillation and it also made them even lighter. Other improvements helped to increase safety and ease-of-use – such as the addition of sensors and step-by-step ‘voice instructions’.  

By the turn of the century, defibrillators had been transformed. Writing about automatic external defibrillators (AEDs) in 2008, experts Mark Kroll, Karl Kroll and Bryon Gilman summed up the modern devices as ‘one of the greatest engineering success stories of the last few decades’. Since then, the technology has continued to progress. As an example, earlier this year St John Ambulance launched its HEART Pocket semi automatic defibrillator. The device weighs just 700g and is, as the name suggests, small enough to fit in a coat pocket.

What Next For Defibrillators?

The technology behind modern defibrillators is truly remarkable. Now, the challenge in the UK and elsewhere is to ensure that members of the public can access these lifesaving devices in an emergency.

It is not realistic, of course, to expect every individual to carry an AED in their bag or pocket everywhere they go. Alongside the cost, the appropriate storage and maintenance of each device would be a concern. However, there is another approach worthy of consideration – that is, for all new cars to include a portable defibrillator as standard. This solution is currently being proposed by the JumpStart Campaign.

The evolution of the defibrillator has been a huge win for emergency medicine. Now, it is time to make sure that this exceptional technology can reach everyone who needs it.

To find out more about the benefits of including defibrillators in new cars, visit www.jumpstartcampaign.co.uk.

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Beck, C. S., Pritchard, W. H., & Feil, H. S. (1947). Ventricular fibrillation of long duration abolished by electric shock. Journal of the American Medical Association, 135(15), 985-986.

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Cakulev, I., Efimov, I. R., & Waldo, A. L. (2009). Cardioversion: Past, Present, and Future. Circulation, 120(16), 1623-1632.

Crutchley, P. (2016). Frank Pantridge, the ‘father of emergency medicine’. BBC.

Gorbunov, B. B., Gusev, A. N., & Selishchev, S. V. (2024). The History of the First Serial DC Defibrillators.

Kroll, M., Kroll, K., & Gilman, B. (2008). Idiot-Proofing the Defibrillator. Spectrum.ieee.org

Lown, B., Amarasingham, R., & Neuman, J. (1962). New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA, 182:548-555.

McWilliam, J. (1989). Cardiac Failure and Sudden Death. British Medical Journal, 1(1462), 6.

National EMS Museum Collection (NEMSM-0234). Heart-Aid Defibrillator. Emsmuseum.org.

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St John Ambulance, (2026). New compact defibrillator puts life-saving power in your pocket. Sja.org.uk.