The V=N/D theoretical framework proposes wave-coherent shock delivery and AMSA-guided timing to overcome the 8-10% global cardiac arrest survival ceiling imposed by current fixed-interval protocols.
Proposes a theoretical redesign of defibrillation protocols, shifting from fixed-interval brute-force shocks to wave-coherent, AMSA-guided, KOKU-aligned shock delivery based on the V=N/D principle.
Current defibrillation practice delivers brute-force Generation layer reset without Wave layer priming, without Nᵢnternal state awareness, and without KOKU scaffold geometry consideration. Four redesign proposals are derived from V=N/D: (I) KOKU-aligned electrode placement minimizing DEMI (grounded in Sepulveda 1989, Trayanova 2011) ; (II) AMSA as measurable proxy for Nᵢnternal relative to Nc 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) → Nc 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.
Yoshimitsu Katayama (Mon,) conducted a review in Cardiac arrest. V=N/D based defibrillation redesign vs. Current fixed-interval defibrillation practice was evaluated. The V=N/D theoretical framework proposes wave-coherent shock delivery and AMSA-guided timing to overcome the 8-10% global cardiac arrest survival ceiling imposed by current fixed-interval protocols.
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