用於小型動物心臟之心室除顫器

Abstract

根據衛生福利局近年國人十大死因統計，心臟疾病皆高居十大死因前三名，而每年有兩萬人發生事故後送到醫院前心跳停止，平均來說，不到半個小時就有一個人因為心臟停止而倒下，且多項研究表示，如果患者倒下或昏迷，沒有立即CPR及AED，十分鐘後送醫，存活率不到2%，若患者倒下立即實施CPR並在救護車到達前給予電擊刺激心臟，存活率提高至20%，但若是在倒下後立即實施CPR及給予心臟電擊刺激再送醫，存活率大大提升至50%。 在本論文，皆以老鼠的離體心臟做研究，成功後再往人體發展，老鼠活著階段，不加以注射藥物改變心律或是抑制身體各項機能，心臟離體時灌流使心臟能維持正常功能，在以電刺激的方式誘發心室顫動，誘發成功後，在使用本研究之AED進行除顫，第一次除顫失敗將在短時間內再次除顫。 臨床上已證明患者如果發生心室搏動過速Ventricular Tachycardia (VT)或是心室顫動Ventricular Fibrillation (VF)等致命性心律不整時，電擊除顫是唯一被證明有效的方法，但因電擊的能量與心臟受到電擊時的損傷成正比，但能量太低也無效果，故本論文除顫的輸出波形有單向與雙向兩種且輸出電壓可調，供使用者需求做更換且達到除顫目的，與設計結果相同。

According to the Ministry of Health and Welfare’s list of the top ten leading causes of death in Taiwan, heart disease is listed as the second most common cause of death in recent years. Every year, more than twenty thousand people die from complications due to heart disease before they reach the hospital. On average, one person will die in this way about every thirty minutes. Furthermore, many studies have shown that if a person collapses or loses consciousness without doing Cardiopulmonary Resuscitation (CPR) and using Automatic External Defibrillator (AED) immediately, the survival rate is less 2% if he arrives at the hospital only ten minutes later. The survival rate rises to 20% when CPR is used immediately after the event occurs. However, if CPR is used in conjunction with AED before the ambulance arrives, the survival rate increases to 50%. We took rat hearts for in vitro research, we did not use any drugs which may affect the heart rate or physical functions, instead we maintained proper function of the in vitro heart via perfusion, and then we used electrical stimulation to trigger ventricular fibrillation. After that, we used our improved AED which increased from 12 volts to 400 volts to defibrillate. The only clinically proven way to treat Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF) is by using electric shock. However, the energy of electric shock and the damage to heart are directly proportional. In our research we use a biphasic wave as the output pattern .Compared to the standard monophasic wave, the biphasic wave reduces the energy usage by half and gives us a high success rate during defibrillation.