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February 1, 1991Circulation Research

Conditioning prepulse of biphasic defibrillator waveforms enhances refractoriness to fibrillation wavefronts.

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Why the study?

Does biphasic waveform stimulation prolong cellular refractoriness to fibrillation wavefronts compared to monophasic stimulation in myocardial cell aggregates?

Population

Myocardial cell aggregates

Comparison

Symmetrical biphasic current injection S2… vs Monophasic current injection S2 stimuli

Design

Preclinical

Authors

JSJohn SwartzKansas City UniversityJJJanice L. JonesUniversity of North Carolina at Chapel HillRJR. E. JonesUniversity Hospitals Bristol NHS Foundation Trust

Discussion

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Overview

Biphasic waveforms may prolong refractoriness in myocardial aggregates; leaves open translation to clinical defibrillation efficacy.

Structured PICO

Does biphasic waveform stimulation prolong cellular refractoriness to fibrillation wavefronts compared to monophasic stimulation in myocardial cell aggregates?

P
Population
Myocardial cell aggregates
I
Intervention
Symmetrical biphasic (10 msec, each pulse) current injection S2 stimuli at 1.5 and two times S1 threshold
C
Comparator
Monophasic (10 msec, rectangular wave) current injection S2 stimuli
O
Outcome
Duration of graded responses and refractoriness to an S3 stimulus (simulating fibrillation wavefront)surrogate

Biphasic waveforms prolong cellular refractoriness compared to monophasic waveforms, providing a cellular mechanism for their greater defibrillation efficacy.

Cite This Study

Swartz et al. (1991) studied this question.

synapsesocial.com/papers/6a75fca774b63c188eb20c82https://doi.org/10.1161/01.res.68.2.438
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Also Consider

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

  1. 1Improved internal defibrillation efficacy with a biphasic waveform1989 · 97 citations
  2. 2Defibrillation of 100 kg calves with asymmetrical, bidirectional, rectangular pulses1984 · 82 citations
  3. 3Transthoracic Ventricular Defibrillation in the 100 kg Calf with Symmetrical One-Cycle Bidirectional Rectangular Wave Stimuli1983 · 88 citations
  4. 4Influence of Ventricular Fibrillation Duration on Defibrillation Energy in Dogs Using Bidirectional Pulse Discharges1988 · 42 citations
  5. 5Periodic Conductivity as a Mechanism for Cardiac Stimulation and Defibrillation1987 · 116 citations