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Improved defibrillator waveform safety factor with biphasic waveforms.

J L Jones, R E Jones

    The American Journal of Physiology
    |July 1, 1983
    PubMed
    Summary
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    Biphasic waveforms show higher safety factors in myocardial cells compared to truncated or rectified waveforms. This suggests biphasic waveforms may improve cardiac defibrillation safety and efficacy.

    Area of Science:

    • Cardiovascular Research
    • Electrophysiology
    • Biomedical Engineering

    Background:

    • Cardiac defibrillation relies on electrical stimulation to correct arrhythmias.
    • Waveform shape significantly impacts defibrillation effectiveness and safety.
    • Biphasic waveforms are hypothesized to mitigate cellular damage from initial positive electrical phases.

    Purpose of the Study:

    • To investigate the impact of different electrical waveform types on myocardial cell excitation thresholds and arrhythmias.
    • To test if the negative phase of biphasic waveforms reduces membrane dysfunction.
    • To compare the safety factors of biphasic, truncated, and rectified waveforms in cultured cardiac cells.

    Main Methods:

    • Cultured adult-type chick embryo myocardial cells were stimulated using biphasic, truncated, and rectified RLC waveforms.

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  • Photocell mechanograms and intracellular microelectrodes monitored cellular responses, including extrasystoles and arrhythmias.
  • Excitation thresholds and shock intensities causing specific dysfunctions were measured to calculate safety factors.

    • Main Results:

    • Rectifying or truncating biphasic waveforms did not alter the excitation threshold.
    • Shock intensities causing specific arrhythmias or prolonged depolarization differed significantly between waveform types.
    • Biphasic waveforms demonstrated significantly higher safety factors than truncated or rectified waveforms.

    Conclusions:

    • Biphasic waveforms exhibit superior safety factors in cultured myocardial cells compared to modified waveforms.
    • The findings suggest that optimized biphasic waveforms could enhance the safety and efficacy of clinical cardiac defibrillation.
    • Waveform shaping is a critical parameter for improving defibrillation outcomes.