Defibrillation current and impedance are determinants of defibrillation energy requirements

The relationship between various electrical descriptors of shocks for cardiac defibrillation is incompletely understood. Defibrillating energy, current, impedance and pulse duration were measured in 18 dogs. They were subject to repeated fibrillation--defibrillation through epicardial patches, with shocks of preset energy and voltage and variable pulse duration, impedance and peak current. Current and energy requirements for defibrillation were calculated. Energy requirements were positively correlated with pulse duration and interelectrode impedance (r = .70, P less than 0.01). Correcting for heart weight, these correlations were no longer present. However, peak current was correlated with energy requirements both before (r = -0.62, P less than 0.05) and after (r = 0.76, P less than 0.01) correcting for heart weight, with energy requirement decreasing as peak current/g heart increased. Current requirements were significantly less variable between animals than energy requirements (.027 +/- .012 joules/g vs .016 +/- .003 Amps/g), suggesting that current per unit heart weight may be a better descriptor than energy for the ability to defibrillate.