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Evaluation of a Unique Defibrillation Unit with Dual‐Vector Biphasic Waveform Capabilities: Towards a Miniaturized Defibrillator
Author(s) -
OKAMURA HIDEO,
DESIMONE CHRISTOPHER V.,
KILLU AMMAR M.,
GILLES EMILY J.,
TRI JASON,
ASIRVATHAM ROSHINI,
LADEWIG DEJAE J.,
SUDDENDORF SCOTT H.,
POWERS JOANNE M.,
WOODWENTZ CHRISTINA M.,
GRAY PETER D.,
RAYMOND DOUGLAS M.,
SAVAGE SHELLEY J.,
SAVAGE WALTER T.,
BRUCE CHARLES J.,
ASIRVATHAM SAMUEL J.,
FRIEDMAN PAUL A.
Publication year - 2017
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 - 10.1111/pace.12979
Subject(s) - defibrillation , ventricular fibrillation , medicine , waveform , defibrillation threshold , shock (circulatory) , fibrillation , cardiology , biomedical engineering , computer science , atrial fibrillation , telecommunications , radar
Background Automated external defibrillators can provide life‐saving therapies to treat ventricular fibrillation. We developed a prototype unit that can deliver a unique shock waveform produced by four independent capacitors that is delivered through two shock vectors, with the rationale of providing more robust shock pathways during emergent defibrillation. We describe the initial testing and feasibility of this unique defibrillation unit, features of which may enable downsizing of current defibrillator devices. Methods We tested our defibrillation unit in four large animal models (two canine and two swine) under general anesthesia. Experimental defibrillation thresholds (DFT) were obtained by delivery of a unique waveform shock pulse via a dual‐vector pathway with four defibrillation pads (placed across the chest). DFTs were measured and compared with those of a commercially available biphasic defibrillator (Zoll M series, Zoll Medical, Chelmsford, MA, USA) tested in two different vectors. Shocks were delivered after 10 seconds of stable ventricular fibrillation and the output characteristics and shock outcome recorded. Each defibrillation series used a step‐down to failure protocol to define the defibrillation threshold. Results A total of 96 shocks were delivered during ventricular fibrillation in four large animals. In comparison to the Zoll M series, which delivered a single‐vector, biphasic shock, the energy required for successful defibrillation using the unique dual‐vector biphasic waveform did not differ significantly (P = 0.65). Conclusions Our early findings support the feasibility of a unique external defibrillation unit using a dual‐vector biphasic waveform approach. This warrants further study to leverage this unique concept and work toward a miniaturized, portable shock delivery system.