page_title: William B. Kouwenhoven
section_title: Closed-chest defibrillator
hierarchical_section_title: William B. Kouwenhoven / Electric cardiac defibrillator / Closed-chest defibrillator
caption_attribution_description: English: Developed at Johns Hopkins University.
context_page_description: William Bennet Kouwenhoven, also known as the "Father of Cardiopulmonary Resuscitation," is famous for his development of the closed-chest cardiac massage and his invention of the cardiac defibrillator. After obtaining his doctorate degree in engineering from the Karlsruhe Technische Hochschule in Germany, Kouwenhoven began his career as the dean at the Johns Hopkins University in Baltimore. Kouwenhoven focused his research mainly on improving and saving lives of patients through the application of electricity. With the help and cooperation of the Johns Hopkins School of Medicine's Department of Surgery and an Edison Electric Institution grant, Kouwenhoven was able to develop a closed-chest defibrillator. For his contributions to the field of medical science, he became the first ever recipient of an honorary degree conferred by the Johns Hopkins School of Medicine. Two years before his death, Kouwenhoven was also awarded the Albert Lasker Award for Clinical Medical Research.
context_section_description: In 1950, Kouwenhoven began his research on a closed-chest defibrillator. Alfred Blalock, the Chief of Surgery at the time, was dubious at first regarding Kouwenhoven's ideas. However, he soon agreed to provide laboratory space and equipment for Kouwenhoven's studies. At first, Kouwenhoven and his team monitored the effect of electrodes on the opposite sides of the chest.  They noted that a brief AC current of 20 amperes was able to jolt a heart from ventricular fibrillation back into a normal sinus rhythm. Samuel Talbot, a surgeon who was studying heart arrhythmias in dogs at the time, asked Kouwenhoven to merge his research on a defibrillator with Talbot's studies. Afterwards, Kouwenhoven observed that the current flowed best vertically instead of horizontally when passed through a dog's heart. By noticing this, he was able to decrease the shock's intensity by 50 percent.
  By 1957, Kouwenhoven and his team had designed a prototype specifically to work on humans. This novel device weighed approximately 200 pounds and consisted of a small box with two insulated cables with copper electrodes, which administered an AC current. One electrode was to be placed over the suprasternal notch, and the other electrode was to be placed over the apex of the heart. In 1961, Kouwenhoven and his team were able to launch the first truly portable defibrillator with the help and support of Mine Safety Appliance Company of Pittsburg. This new portable device weighed 45 pounds, and it could fit in a small plastic suitcase.
  Guy Knickerbocker, an electrical engineer working at Kouwenhoven's laboratory, discovered that the copper electrodes caused a rise in blood pressure in the rest of the body when they were pressed down onto a dog's chest even before the current was passed through them. He hypothesized that massaging the chest in a rhythmical manner causes the blood to circulate. This observation paved the path for the third major discovery by Kouwenhoven's team: cardiopulmonary resuscitation also known as CPR.
caption: Closed-Chest Defibrillator developed at Johns Hopkins University.
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