Putting it into simple terms, a pacemaker helps the heart beat whereas a defibrillator stops the heart for a moment. Pacemakers generate electrical activity in the heart for patients with certain cardiac arrythmias. A defibrillator actually generates a shock so strong that it stops the heart's electrical activity. The heart (unlike most muscles) generates its own electrical impulse and can therefore hopefully restart itself after this big shock. Defibrillators are usually used for more serious cardiac arrythmias.
Yes, a very big difference:
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