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Transthoracic defibrillation of dogs with Edmark, biphasic, and quadriphasic waveforms
Wayne C McDaniel1, Thomas Magin, Richard W Madsen
1Division of Cardiothoracic Surgery, University of Missouri, Columbia, MO 65212, USA. mcdanielwc@missouri.edu
Journal of Electrocardiology
|January 12, 2002
Summary
Quadriphasic truncated exponential (QTE) and biphasic truncated exponential (BTE) waveforms show superior defibrillation efficacy compared to Edmark. QTE demonstrated an advantage over BTE in simulated high impedance patients.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Electrophysiology
Background:
- High transthoracic impedance increases risk for patients undergoing defibrillation.
- Current defibrillation waveforms may have suboptimal efficacy in high impedance scenarios.
Purpose of the Study:
- To compare the defibrillation efficacy of biphasic truncated exponential (BTE), quadriphasic truncated exponential (QTE), and Edmark waveforms.
- To evaluate waveform performance across simulated low, average, and high transthoracic impedance levels.
Main Methods:
- Waveform efficacy tested in anesthetized dogs (n=15) at simulated impedance levels.
- Two energy levels were used, with random order application.
- A supplemental study estimated ED50 peak current for BTE and QTE at high impedance.
Main Results:
- BTE and QTE were equivalent and superior to Edmark at equal delivered energies (P<.0001).
- At 24 J in simulated high impedance, QTE (71%) was superior to BTE (49%) (P=.011).
- QTE required lower mean ED50 peak current than BTE in high impedance (7.9 vs. 8.9 A, P=.0049).
Conclusions:
- Both QTE and BTE waveforms are superior to Edmark across various impedance levels.
- QTE shows potential superiority over BTE for defibrillation in patients with simulated high transthoracic impedance.