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Related Experiment Videos

Improved safety factor for triphasic defibrillator waveforms.

J L Jones1, R E Jones

  • 1Department of Physiology and Biophysics, School of Medicine, Georgetown University, Washington, DC 20037.

Circulation Research
|June 1, 1989
PubMed
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A novel triphasic waveform enhances defibrillation efficacy by improving the safety factor. This new waveform shows greater effectiveness than biphasic waveforms in preventing postshock dysfunction in myocardial cells.

Area of Science:

  • Cardiovascular Research
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Biphasic waveforms improve defibrillation efficacy by reducing defibrillation threshold and shock-induced dysfunction.
  • Symmetrical biphasic waveforms lower defibrillation threshold but increase postshock arrhythmias.
  • Biphasic waveforms with "tails" reduce postshock arrhythmias.

Purpose of the Study:

  • To test the hypothesis that a triphasic waveform can combine the benefits of biphasic waveforms for improved defibrillation efficacy and safety.
  • To evaluate the safety factor of a novel triphasic waveform compared to monophasic and biphasic waveforms.

Main Methods:

  • Cultured myocardial cells were stimulated with monophasic, symmetrical biphasic, and triphasic waveforms.
  • Waveform portions were 5 msec in duration.

Related Experiment Videos

  • Contractile activity was monitored using photocell mechanograms to assess postshock dysfunction.

    • Main Results:

    • Postshock arrest duration increased with stimulus intensity for all waveforms.
    • The voltage gradient for a 4-second arrest was 80.6% of control for biphasic waveforms and 87.1% for triphasic waveforms.
    • The difference in effectiveness between biphasic and triphasic waveforms was statistically significant (p < 0.001).

    Conclusions:

    • The triphasic waveform demonstrated a significantly higher safety factor than the biphasic waveform.
    • Combining independent mechanisms for defibrillation improvement into a triphasic waveform is effective.
    • This triphasic waveform shows promise for enhanced defibrillation therapy.