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Related Experiment Videos

Overlapping sequential pulses. A new waveform for transthoracic defibrillation

R E Kerber1, K T Spencer, M J Kallok

  • 1Cardiovascular Center, University of Iowa Hospital, Iowa City 52242.

Circulation
|May 1, 1994
PubMed
Summary

New overlapping sequential pulse shocks improve defibrillation success rates compared to single pulse shocks. This novel waveform facilitates defibrillation by altering the electrical vector during transthoracic defibrillation.

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Area of Science:

  • Cardiovascular Research
  • Electrophysiology
  • Medical Device Technology

Background:

  • A directionally changing electrical vector can enhance defibrillation by depolarizing myocytes with varied orientations.
  • Overlapping sequential pulses represent a novel waveform for transthoracic defibrillation designed to achieve a changing electrical vector.

Purpose of the Study:

  • To evaluate the efficacy of a new overlapping sequential pulse waveform for transthoracic defibrillation.

Main Methods:

  • Ventricular fibrillation was induced in closed-chest dogs.
  • Sequential overlapping pulse shocks (two 5.0-ms pulses with 2.5-ms overlap) and single pulse shocks (7.5-ms) were administered.
  • Two electrode placements with different vector orientations were studied; intracardiac electrodes confirmed vector changes.

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Main Results:

  • Overlapping pulse shocks demonstrated significantly higher defibrillation success rates than single pulse shocks at equivalent energies (50, 100, 150 J).
  • At 50 J, success rates for overlapping pulses were 39-55% versus 0-14% for single pulses (P < .05).
  • At 150 J, success rates for overlapping pulses were 91-95% versus 45-61% for single pulses (P < .05).

Conclusions:

  • Sequential overlapping pulse shock waveforms are more effective for defibrillation than single pulse shocks of the same total energy.
  • The improved efficacy is attributed, in part, to the dynamic orientation of the electrical vector during the sequential overlapping shock.