Key result
New V=N/D defibrillation framework suggests ~10% cardiac arrest survival stems from device design, not biology.
Why the study?
Current defibrillation practice delivers brute-force reset without Wave layer priming, internal state awareness, or scaffold geometry consideration.
Proposes a theoretical paradigm shift in defibrillation from fixed-interval brute-force shocks to wave-coherent, AMSA-guided, and KOKU-aligned protocols based on the V=N/D principle.
Current defibrillation practice delivers brute-force Generation layer reset without Wave layer priming, without N_internal state awareness, and without KOKU scaffold geometry consideration. Four redesign proposals are derived from V=N/D: (I) KOKU-aligned electrode placement minimizing D_EMI (grounded in Sepulveda 1989, Trayanova 2011); (II) AMSA as measurable proxy for N_internal relative to N_c threshold — enabling real-time optimal shock timing replacing fixed 2-minute intervals (grounded in Callaway 2015, Freese 2007); (III) wave-coherent shock waveform design replacing biphasic rectangular with KOKU-resonant energy profiles (grounded in Walcott 2003); (IV) three-phase protocol: Wave priming (CPR + sub-threshold resonance pacing) → N_c detection (AMSA monitoring) → Wave-coherent KOKU-aligned defibrillation. V=N/D unifies 30 years of defibrillation optimization research under a single physical principle. Global cardiac arrest survival (8-10%) is a ceiling imposed by pump-model design, not biology.
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Yoshimitsu Katayama (2026) studied Cardiac arrest. Wave-coherent shock delivery and AMSA-guided defibrillation vs. Current fixed-interval defibrillation practice was evaluated. A proposed V=N/D theoretical framework for defibrillation redesign suggests that current global cardiac arrest survival of 8-10% is limited by pump-model design rather than biology.
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