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Open‐Chest Epicardial “Surgical” Defibrillation:
Author(s) -
ZHANG YI,
DAVIES LOYD R.,
CODDINGTON WILLIAM J.,
ZIMMERMAN M. BRIDGET,
WUTHRICH SCOTT,
JONES JANICE L.,
KERBER RICHARD E.
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.00121.x
Subject(s) - paddle , defibrillation , medicine , ventricular fibrillation , cardiology , shock (circulatory) , waveform , anesthesia , materials science , voltage , physics , quantum mechanics , composite material
ZHANG, Y., et al .: Open‐Chest Epicardial “Surgical” Defibrillation: Biphasic Versus Monophasic Waveform Shocks.The aim of the study was to compare biphasic versus monophasic shocks for open‐chest epicardial defibrillation. Transthoracic biphasic waveform shocks require less energy to terminate ventricular fibrillation compared to monophasic waveform shocks. However, if biphasic shocks are effective for open‐chest epicardial (“surgical”) defibrillation has not been established. Twenty‐eight anesthetized adult swine (15–25 kg) underwent a midline sternotomy. Ventricular fibrillation was electrically induced. After 15 seconds of ventricular fibrillation, each pig in group 1(n = 16)randomly received damped sinusoidal monophasic epicardial shocks and truncated exponential biphasic epicardial shocks from large(44.2 cm 2 )paddle electrodes at eight energy levels(2–50 J). Pigs in group 2 (n = 12) received monophasic and truncated exponential biphasic shocks from small (15.9 cm 2 ) paddle electrodes. In group 1 (large paddle electrodes), the overall percent shock success rose from 15 ± 9% at 2 J to 97 ± 3% at 50 J. In this group there was no significant difference in percent of shock success between damped sinusoidal monophasic and biphasic waveform shocks. In group 2 (small paddle electrodes), biphasic shocks yielded a significantly higher percent of shock success than monophasic shocks at mid‐energy levels from 7 to 20 J (all P < 0.01 ). With small surgical paddle electrodes, biphasic waveform shocks demonstrated a significantly higher percent of shock success rate compared to monophasic waveform shocks. With large paddle electrodes, the two waveforms were equally effective. (PACE 2003; 26:711–718)