The Energy for Ventricular Defibrillation — Too Little or Too Much?

The introduction of direct-current discharge defibrillation into clinical use1 has provided a high yield of resuscitations and has gained universal acceptance. It seemed until recently that this starkly simple electronic device would withstand the onslaught of technologic innovation and inevitable obsolescence. Although the technic is not being challenged, under question is the adequacy of energy being provided by present-day instruments.2 3 4 The general thesis being espoused by the proponents of an energy-dose concept is that body weight is an important determinant of defibrillation energy requirements and that apparatus in current use are inadequate for heavy subjects. This is an issue of . . .