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Related Experiment Videos

Electrode system influence on biphasic waveform defibrillation efficacy in humans.

G H Bardy1, C Troutman, G Johnson

  • 1Department of Medicine, University of Washington, Seattle 98195.

Circulation
|August 1, 1991
PubMed
Summary

Biphasic waveform defibrillation is generally superior to monophasic for cardiac arrest survivors, proving more effective with various lead systems. However, its efficacy varies depending on the specific electrode configuration used.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Clinical studies indicate biphasic waveform defibrillation is superior to monophasic using epicardial leads.
  • This study evaluated biphasic waveform defibrillation efficacy across different lead systems in cardiac arrest survivors.

Purpose of the Study:

  • To assess the broad utility of biphasic waveforms in humans.
  • To compare defibrillation efficacy of monophasic and biphasic waveforms for epicardial and nonthoracotomy lead systems.

Main Methods:

  • Prospective, randomized evaluation in 51 cardiac arrest survivors undergoing automatic defibrillator implantation.
  • Tested three lead configurations: epicardial RV-LV, nonthoracotomy RV-CP, and nonthoracotomy CS-RV.
  • Measured defibrillation threshold voltage, current, resistance, and stored energy using a digital oscilloscope.

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Main Results:

  • Biphasic waveforms were more efficient than monophasic for epicardial RV-LV (4.8 vs. 6.7 J) and RV-CP (23.4 vs. 34.3 J) systems (p<0.05).
  • No significant difference in efficacy was found for the CS-RV system (15.6 vs. 20.0 J, p=0.11).
  • Biphasic was more efficacious in 65% of RV-LV, 67% of RV-CP, and 56% of CS-RV patients.

Conclusions:

  • Biphasic waveform defibrillation is effective with both epicardial and nonthoracotomy lead systems.
  • The superiority of biphasic waveforms is dependent on the specific electrode system used.
  • In some individuals, biphasic waveform defibrillation was less efficient than monophasic, irrespective of the lead system.