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Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks

P A Guse1, D L Rollins, W Krassowska

  • 1Department of Medicine, Duke University Medical Center, Durham, NC 27710.

Pacing and Clinical Electrophysiology : PACE
|August 1, 1993
PubMed
Summary
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New biphasic shock sequences significantly lowered defibrillation thresholds (DFTs) in pigs. These findings suggest improved strategies for effective internal defibrillation using novel sequential and interleaved biphasic waveforms.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Low defibrillation thresholds (DFTs) are crucial for effective internal defibrillation.
  • Sequential timing and biphasic shocks have previously shown promise in reducing DFTs.

Purpose of the Study:

  • To evaluate the defibrillation efficacy of two novel shock sequences: interleaved biphasic and common phase sequential biphasic.
  • To compare these new sequences against traditional monophasic and single biphasic waveforms.

Main Methods:

  • Two-part study using anesthetized pigs (n=6 and n=9).
  • Utilized a multi-electrode configuration including right ventricle, superior vena cava, LV apex, and thoracic patch.
  • Measured defibrillation threshold energies for various biphasic and monophasic shock sequences.

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Main Results:

  • Interleaved biphasic and common phase sequential biphasic waveforms showed significantly lower DFTs compared to sequential monophasic and single biphasic waveforms (P < 0.0001).
  • Phase reversal in common phase sequential biphasic shocks was critical, with biphasic shocks demonstrating much lower DFTs than monophasic counterparts (P < 0.0001).
  • The efficacy of common phase sequential biphasics was comparable to sequential biphasics.

Conclusions:

  • Novel interleaved biphasic and common phase sequential biphasic shock sequences are highly effective in reducing defibrillation thresholds.
  • These findings support the potential of these advanced biphasic waveforms for improved internal defibrillation strategies.
  • Possible mechanisms include enhanced myocardial shock exposure and optimized potential gradients during sequential phases.