Key result
Biphasic waveforms outperform monophasic shocks for ventricular defibrillation in animal models despite unclear mechanisms.
Why the study?
Does the type of shock waveform (e.g., biphasic vs. monophasic) improve ventricular defibrillation efficacy?
Does the type of shock waveform (e.g., biphasic vs. monophasic) improve ventricular defibrillation efficacy?
This review highlights the historical progression of defibrillation waveforms and notes evidence from animal studies supporting the superiority of biphasic over monophasic shocks.
Should not change clinical defibrillation practice; leaves open mechanisms and human translation.
The early use of AC waveforms for ventricular defibrillation is briefly recounted. Research on the efficacy of damped sinusoidal, truncated, and biphasic waveforms is reviewed. It is noted that damped sinusoidal and monophasic truncated exponential waveforms have been used successfully for decades in clinical settings and the further improvements can be made by altering the applied waveforms. Studies in animals suggest the superiority of biphasic over monophasic waveforms; the causes for these improvements have not yet been completely elucidated. Results indicate that the response of the myocardium to electric shocks is complex.
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Alferness et al. (1990) conducted a review in Ventricular defibrillation. Biphasic waveforms vs. Monophasic waveforms was evaluated. Animal studies suggest the superiority of biphasic over monophasic waveforms for ventricular defibrillation, though the mechanisms remain incompletely elucidated.
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