Key result
Pulse-width modulated biphasic waveforms lower defibrillation thresholds and post-shock disturbances versus standard pulses.
Why the study?
Different biphasic pulses for transthoracic defibrillation vary in efficiency and post-shock effects, motivating evaluation of chopping-modulated biphasic waveforms.
Does a pulse-width modulated biphasic waveform reduce threshold defibrillation energy and post-shock disturbances compared to standard waveforms in animal models?
Does a pulse-width modulated biphasic waveform reduce threshold defibrillation energy and post-shock disturbances compared to standard waveforms in animal models?
A novel pulse-width modulated biphasic waveform improves defibrillation efficacy by lowering energy thresholds and reducing post-shock disturbances in animal models.
Novel waveform cuts energy thresholds in animals; leaves clinical translation open pending human trials.
The superiority of different biphasic pulses for transthoracic defibrillation was proven by several studies. These efficient waveforms were implemented in some commercially available defibrillators. Recently we have devised and evaluated a biphasic waveform with a specially balanced ratio of the first-to-second phase voltages and with 5 kHz frequency 1:1 on-off chopping. It used less than half the energy for successful defibrillation in comparison with the 'classic' monophasic damped sinusoidal wave and showed considerably less post-shock negative effects. This experience led us to try several laws of chopping modulation. A pulse-width modulation, combining low energy with gradual upslope of the modelled transmembrane potential, proved to have better performance than the standard damped sinusoid wave and the non-chopped biphasic truncated exponential pulse. This waveform was tested in a series of animal experiments in comparison with other modulated pulses, with the non-modulated waveform and the standard damped sinusoid wave. The experiments demonstrated the superiority of the modulated waveform, assessed by combining the parameters of threshold defibrillation energy and of post-shock disturbances reduction.
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Vessela Krasteva (2001) studied Transthoracic defibrillation. Pulse-width modulated biphasic waveform vs. Standard damped sinusoid wave and non-chopped biphasic truncated exponential pulse was evaluated on Threshold defibrillation energy and post-shock disturbances reduction. A pulse-width modulated biphasic waveform demonstrated superiority over standard damped sinusoid and non-chopped biphasic pulses for threshold defibrillation energy and post-shock disturbances.
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