What question did this study set out to answer?

To evaluate whether delivering remaining capacitor charge across multiple pathways via sequential-biphasic shocks reduces defibrillation thresholds compared to single-biphasic shocks.

June 1, 1997Pacing and Clinical Electrophysiology

Comparison of Single‐Biphasic Versus Sequential‐Biphasic Shocks on Defibrillation Threshold in Pigs

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Why the study?

Does sequential-biphasic shock reduce defibrillation threshold compared to single-biphasic shock in a porcine model?

Population

8 open-chest anesthetized pigs with four mesh electrodes sutured on the epicardium of the anterior and…

Comparison

Sequential-biphasic shock delivered to separate… vs Single-biphasic shock delivered to coupled pairs…

Design

Preclinical, randomized crossover design

Authors

ZCZoltán CsanádiElectrophysiology DJDouglas L. JonesElectrophysiology GWG. Kim WoodWestern University

Discussion

Member takes

Implication

Sequential-biphasic shocks may lower DFT energy in models; hypothesis-generating in animals and should not change practice.

Key Points

To evaluate whether delivering remaining capacitor charge across multiple pathways via sequential-biphasic shocks reduces defibrillation thresholds compared to single-biphasic shocks.
Conducted in eight open-chest anesthetized pigs (N=8) fitted with four mesh electrodes sutured to the anterior and posterior epicardial surfaces of each ventricle.
Delivered single-biphasic shocks (two 5-ms pulses) and sequential-biphasic shocks (four 5-ms pulses) from a 200-microF capacitor bank using a randomized crossover design with triplicate defibrillation threshold measurements.
Initial leading edge voltage was significantly lower for sequential-biphasic shocks compared to single-biphasic shocks (mean ± SEM: 420 ± 33 V vs. 497 ± 34 V; P < 0.05).
Sequential-biphasic waveforms resulted in significantly lower initial peak current than single-biphasic waveforms (4.8 ± 0.4 A vs. 13 ± 1.1 A; P < 0.001).
Delivered energy at the defibrillation threshold was reduced by nearly half with sequential-biphasic shocks compared to single-biphasic shocks (16.9 ± 2.6 J vs. 30.4 ± 5.3 J; P < 0.05).

Structured PICO

Does sequential-biphasic shock reduce defibrillation threshold compared to single-biphasic shock in a porcine model?

Population

8 open-chest anesthetized pigs with four mesh electrodes sutured on the epicardium of the anterior and posterior surfaces of each ventricle

Intervention

Sequential-biphasic shock (four 5-ms pulses separated by 0.2 ms) delivered to separate opposing electrodes from a 200-microF capacitor bank

Comparator

Single-biphasic shock (two 5-ms pulses separated by 0.2 ms) delivered to coupled pairs of electrodes from the same capacitor bank

Outcome

Defibrillation threshold (DFT) measured by initial leading edge voltage, initial peak current, and delivered energysurrogate

In a porcine model, sequential-biphasic shocks significantly reduced defibrillation thresholds compared to single-biphasic shocks, suggesting a more efficient method for direct heart defibrillation.

Cite This Study

Csanádi et al. (1997) studied this question.

synapsesocial.com/papers/6a726344e5469ee92be2639e https://doi.org/10.1111/j.1540-8159.1997.tb03528.x

Topics

Cardiac device therapy

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Comparison of Single‐Biphasic Versus Sequential‐Biphasic Shocks on Defibrillation Threshold in Pigs

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Comparison of Single‐Biphasic Versus Sequential‐Biphasic Shocks on Defibrillation Threshold in Pigs

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider