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Updated: Oct 4, 2025
Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
Pediatric defibrillation shocks alone do not cause heart damage in a porcine model
Ben McCartney1,2, Adam Harvey2, Amy Kernaghan2
1Faculty of Computing, Engineering & Built Environment, Ulster University, Newtownabbey, United Kingdom.
Insights
Different automated external defibrillator (AED) pediatric protocols show similar safety and efficacy in pigs. This suggests variations in AED pediatric settings do not impact defibrillation outcomes.
Area of Science:
- Cardiology
- Biomedical Engineering
- Pediatric Resuscitation
Background:
- Automated external defibrillators (AEDs) utilize diverse pediatric shock protocols.
- Variations in waveform, voltage, duration, and phase characteristics exist.
- Assessing the comparative safety and efficacy of these protocols is crucial.
Purpose of the Study:
- To compare the safety and efficacy of two distinct AED pediatric shock protocols (A and B).
- To evaluate myocardial damage and cardiac function following defibrillation.
- To assess defibrillation success and return of spontaneous circulation (ROSC).
Main Methods:
- Two protocols were tested: Protocol A (escalating 50-75-90 J) and Protocol B (non-escalating 50-50-50 J).
- Experiment 1 assessed isolated shock damage in pigs (n=12) via cardiac function, troponin I, CPK, and histopathology.
- Experiment 2 evaluated defibrillation safety and efficacy in pigs (n=10) during ventricular fibrillation (VF), measuring shock success, ROSC, and contractility.
Main Results:
- No significant differences in cardiac biomarkers (cTnI, CPK), ejection fraction, or histopathological damage were found between protocols.
- Both protocols demonstrated high shock success rates (≥97.5%) and ROSC.
- Post-ROSC cardiac contractility was comparable between the two defibrillation protocols.
Conclusions:
- This study found no evidence of significant myocardial damage from clinically relevant AED pediatric shock sequences in the tested model.
- Variations in AED pediatric mode settings do not appear to affect defibrillation safety or efficacy.
- Findings support the consistent safety and effectiveness of current AED pediatric protocols.
Aim:
Automated external defibrillators (AEDs) use various shock protocols with different characteristics when deployed in pediatric mode. The aim of this study is to assess and compare the safety and efficacy of different AED pediatric protocols using novel experimental approaches.
Methods:
Two defibrillation protocols (A and B) were assessed across two studies: Protocol A: escalating (50-75-90 J) defibrillation waveform with higher voltage, shorter duration and equal phase durations. Protocol B; non-escalating (50-50-50 J) defibrillation waveform with lower voltage, longer duration and unequal phase durations.Experiment 1: Isolated shock damage was assessed following shocks to 12 anesthetized pigs. Animals were randomized into two groups, receiving three shocks from Protocol A (50-75-90 J) or B (50-50-50 J). Cardiac function, cardiac troponin I (cTnI), creatine phosphokinase (CPK) and histopathology were analyzed. Experiment 2: Defibrillation safety and efficacy were assessed through shock success, ROSC, ST-segment deviation and contractility following 16 randomized shocks from protocol A or B delivered to 10 anesthetized pigs in VF.
Results:
Experiment 1: No clinically meaningful difference in cTnI, CPK, ST-segment deviation, ejection fraction or histopathological damage was observed following defibrillation with either protocol. No difference was observed between protocols at any timepoint. Experiment 2: all defibrillation types demonstrated shock success and ROSC ≥ 97.5%. Post-ROSC contractility was similar between protocols.
Conclusions:
There is no evidence that administration of clinically relevant shock sequences, without experimental confounders, result in significant myocardial damage in this model of pediatric resuscitation. Typical variations in AED pediatric mode settings do not affect defibrillation safety and efficacy.
