Waveforms for defibrillation and cardioversion: Recent experimental and clinical studies

Current Opinion in Critical Care

Volumn 10, Issue 3, 2004, Pages 202-207

  White, Roger D ^a,b  

^a MAYO CLINIC   (United States)

^b Mayo Clinic   (United States)

Author keywords

Atrial fibrillation; Biphasic waveforms; Cardioversion; Defibrillation; Monophasic waveforms; Triphasic waveforms; Ventricular fibrillation

Indexed keywords

BODY WEIGHT; CARDIOVERSION; DEFIBRILLATION; ELECTRIC SHOCK; HEART FUNCTION; HEART VENTRICLE FIBRILLATION; HUMAN; NONHUMAN; REVIEW; TREATMENT OUTCOME; WAVEFORM; CLINICAL TRIAL; ELECTROSTIMULATION; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; INTENSIVE CARE; METHODOLOGY;

ARRHYTHMIA; ATRIAL FIBRILLATION; CLINICAL TRIALS; CRITICAL CARE; ELECTRIC COUNTERSHOCK; ELECTRIC STIMULATION; HUMANS; TREATMENT OUTCOME; VENTRICULAR FIBRILLATION;

EID: 4644224729     PISSN: 10705295     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.ccx.0000125495.84614.b2     Document Type: Review

References (25)

1. White RD: New concepts in transthoracic defibrillation. Emerg Med Clin North Am 2002, 20:785-807. This review provides useful background on defibrillation waveforms and contains an in-depth analysis of clinically used biphasic waveforms.
2. Clark CB, Zhang Y, Davies LR, et al.: Transthoracic biphasic waveform defibrillation at very high and very low energies: a comparison with monophasic waveforms in an animal model of ventricular fibrillation. Resuscitation 2002, 54:183-186.
3. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation (suppl) 2000, 102:I22-I59.
4. Walker RG, Melnick SB, Chapman FW: Comparison of six clinically used external defibrillators in swine. This article is of interest because this experimental study compares clinically used defibrillation waveforms, although the conclusions must be interpreted in light of the controversy regarding impedance measurement methodology (see [5,6]).
5. Jones JL, Snyder DE, Morgan C: Predictions from misleading pig model are potentially harmful to humans [letter]. Resuscitation 2003, 59:365-367.
6. Walker RG, Chapman FW, Schmitt PW, et al.: Response to Jones et al letter. Resuscitation 2003, 59:367-371.
7. Zhang Y, Davies LR, Coddington WJ: et al: Open-chest epicardial "surgical" defibrillation: biphasic versus monophasic waveform shocks. Pace 2003, 26:711-718.
8. Niemann JT, Garner D, Lewis RJ: Left ventricular function after monophasic and biphasic waveform defibrillation: the impact of cardiopulmonary resuscitation time on contractile indices. Acad Emerg Med 2003, 10:9-15.
9. Tang W, Weil MH, Sun S, et al.: The effects of biphasic and conventional monophasic defibrillation on postresuscitation myocardial function. J Am Coll Cardiol 1999, 34:815-822.
10. Zhang Y, Clark CB, Davies LR, et al.: Body weight is a predictor of biphasic shock success for low energy transthoracic defibrillation. Resuscitation 2002. 54:281-287.
11. Calle PA, Monsieurs KG, Buylaert WA: Equivalence of the standard monophasic waveform shocks delivered by automated external defibrillators? Resuscitation 2002, 53:41-46.
12. Schwarz B, Bowdle TA, Jett GK, et al.: Biphasic shocks compared with monophasic damped sine wave shocks for direct ventricular defibrillation during open heart surgery. Anesthesiology 2003, 98:1063-1069. This is a well-designed clinical study with direct clinical practice implications for epicardial defibrillation.
13. Carpenter J, Rea TD, Murray JA, et al.: Defibrillation waveform and post-shock rhythm in out-of-hospital ventricular fibrillation cardiac arrest. Resuscitation 2003, 59:189-196.
14. van Alem AP, Chapman FW, Lank P, et al.: A prospective, randomized and blinded comparison of first shock success of monophasic and biphasic waveforms in out-of-hospital cardiac arrest. Resuscitation 2003, 58:17-24. This clinical study demonstrates the greater efficacy of a specific BTE waveform when compared with an MDS waveform in out-of-hospital cardiac arrest.
15. Faddy SC, Powell J, Craig JC: Biphasic and monophasic shocks for transthoracic defibrillation: a meta analysis of randomized controlled trials. Resuscitation 2003, 58:9-16.
16. Walcott GP, Killingsworth CR, Ideker RE: Do clinically relevant transthoracic defibrillation energies cause myocardial damage and dysfunction? Resuscitation 2003, 59:59-70.
17. Poole JE, White RD, Kanz K, et al.: Low-energy impedance-compensating biphasic waveforms terminate ventricular fibrillation at high rates in victims of out-of-hospital cardiac arrest. J Cardiovasc Electrophysiol 1997, 8:1373-1385.
18. Caffrey SL, Willoughby PJ, Pepe PE, et al.: Public use of automated external defibrillators. N Engl J Med 2002, 347:1242-1247.
19. Khaykin Y, Newman D, Kowalewski M: et al: Biphasic versus monophasic cardioversion in shock-resistant atrial fibrillation: a randomized clinical trial. J Cardiovasc Electrophysiol 2003, 14:868-872.
20. Page RL, Kerber RE, Russell JK, et al.: Biphasic versus monophasic shock waveform for conversion of atrial fibrillation. J Am Coll Cardiol 2002, 39:1956-1963. A randomized, double-blind, multicenter study demonstrates the superiority of a specific BTE waveform compared with an MDS waveform for cardioversion of atrial fibrillation.
21. Marinsek M, Larkin GL, Zohar P, et al.: Efficacy and impact of monophasic versus biphasic countershocks for transthoracic cardioversion of persistent atrial fibrillation. Am J Cardiol 2003, 92:988-991.
22. Neal S, Ngarmukos T, Lessard D, et al.: Comparison of the efficacy and safety of two biphasic defibrillator waveforms for the conversion of atrial fibrillation to sinus rhythm. Am J Cardiol 2003, 92:810-814. This prospective, randomized, single-center study compares two biphasic waveforms (BTE and BRL). No significant differences were observed relative to efficacy or safety.
23. Kidwai BJ, McIntyre A, Anderson J, et al.: Optimization of transthoracic ventricular defibrillation-biphasic and triphasic shocks, waveform rounding, and synchronized shock delivery. J Electrocardiol 2002, 35:235-244.
24. Zhang Y, Ramabadran RS, Boddicker KA, et al.: Triphasic waveforms are superior to biphasic waveforms for transthoracic defibrillation. J Am Coll Cardiol 2003, 42:568-575.
25. McDaniel WC, Magin T, Madsen RW, et al.: Transthoracic defibrillation of dogs with Edmark, biphasic, and quadriphasic waveforms. J Electrocardiol 2002, 35:45-52.