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September 1, 1990Pacing and Clinical Electrophysiology

Electrophysiological Effects of Monophasic and Biphasic Stimuli in Normal and Infarcted Dogs

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Why the study?

Does biphasic stimulation compared to monophasic stimulation alter electrophysiological parameters and defibrillation thresholds in normal and infarcted dogs?

Population

27 dogs (9 normal, 12 with myocardial infarction, and 6 additional dogs for probability curves)

Comparison

5.5-msec biphasic waveform stimulation vs 5.5 msec monophasic waveform stimulation

Design

Preclinical

Authors

JWJ. Marcus WhartonVRVincent RichardCMCharles E. Murry

Discussion

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Overview

Biphasic benefits in canine models should not yet change ICD practice; leaves open translation to human defibrillation optimization.

Structured PICO

Does biphasic stimulation compared to monophasic stimulation alter electrophysiological parameters and defibrillation thresholds in normal and infarcted dogs?

P
Population
27 dogs (9 normal, 12 with myocardial infarction, and 6 additional dogs for probability curves)
I
Intervention
5.5-msec biphasic (3.5 msec first phase) waveform stimulation
C
Comparator
5.5 msec monophasic waveform stimulation
O
Outcome
Electrophysiological parameters including activation threshold (AT), effective refractory period (ERP), strength-interval curves, ventricular fibrillation threshold (VFT), upper limit of vulnerability (ULV), and defibrillation threshold (DFT)surrogate

Biphasic waveforms decrease defibrillation thresholds and the upper limit of vulnerability compared to monophasic waveforms, independent of the presence or size of myocardial infarction.

Cite This Study

Wharton et al. (1990) studied this question.

synapsesocial.com/papers/6a726344e5469ee92be263a1https://doi.org/10.1111/j.1540-8159.1990.tb02174.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Strength‐Duration Curves of Fixed Pulse Width Variable Tilt Truncated Exponential Waveforms for Nonthoracomy Internal Defibrillation in Dogs1988 · 45 citations
  2. 2Hemodynamic effects of ventricular defibrillation1970 · 77 citations
  3. 3Strength-interval relations in a chronic canine model of myocardial infarction. Implications for the interpretation of electrophysiologic studies.1981 · 30 citations
  4. 4The relationship between successful defibrillation and delivered energy in open-chest dogs: Reappraisal of the “defibrillation threshold” concept1987 · 217 citations
  5. 5Transthoracic Ventricular Defibrillation with Square-wave Stimuli: One-Half Cycle, One Cycle, and Multicycle Waveforms1964 · 63 citations