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Changes in transthoracic impedance during sequential biphasic defibrillation.

Charles D Deakin¹, Jonathan J S Ambler, Steven Shaw

¹Shackleton Department of Anaesthetics, Southampton University Hospital NHS Trust, Tremona Road, Southampton SO16 6YD, UK. charlesdeakin@doctors.org.uk

|May 20, 2008

Summary

This summary is machine-generated.

Sequential biphasic defibrillation, like monophasic, reduces transthoracic impedance (TTI). This study confirms that sequential biphasic shocks decrease TTI in patients undergoing elective cardioversion, impacting defibrillation protocols.

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Published on: December 11, 2017

Area of Science:

Cardiology
Electrophysiology

Background:

Sequential monophasic defibrillation is known to reduce transthoracic impedance (TTI).
The impact of sequential biphasic shocks on TTI was previously uncharacterized.
This study investigated TTI changes during biphasic waveform cardioversion.

Purpose of the Study:

To determine if sequential biphasic defibrillation decreases transthoracic impedance (TTI).
To assess the clinical relevance of TTI changes during elective cardioversion with biphasic waveforms.

Main Methods:

Adults undergoing elective DC cardioversion for atrial flutter/fibrillation received sequential biphasic shocks.
An escalating energy protocol (70J-300J) was used with a truncated exponential biphasic waveform.
Transthoracic impedance (TTI) was measured electronically via the defibrillator circuit.

Main Results:

Sequential biphasic defibrillation significantly decreased TTI with each successive shock.
The initial mean TTI was 92.2 Ohms, decreasing to 85.0 Ohms in patients receiving five shocks.
Cardioversion was successful in 93.1% of the 58 patients studied.

Conclusions:

Sequential biphasic defibrillation demonstrably reduces TTI, similar to monophasic waveforms.
This impedance reduction may be more pronounced during cardiac arrest due to rapid shock delivery and reduced cutaneous blood flow.
Biphasic defibrillators' ability to adjust waveforms based on TTI likely mitigates potential impacts on defibrillation efficacy.