A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits

Abstract Defibrillation is accomplished by the passage of sufficient current through the heart to terminate ventricular fibrillation (VF). Although current-based defibrillation has been shown to be superior to energy-based defibrillation with monophasic waveforms, defibrillators with biphasic wavefo...

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Autores principales:	Weiming Li, Jingru Li, Liang Wei, Jianjie Wang, Li Peng, Juan Wang, Changlin Yin, Yongqin Li
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ac94c1f7dd6d4be19a6e68a3b5926f7f
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spelling	oai:doaj.org-article:ac94c1f7dd6d4be19a6e68a3b5926f7f2021-12-02T14:02:34ZA framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits10.1038/s41598-020-80521-92045-2322https://doaj.org/article/ac94c1f7dd6d4be19a6e68a3b5926f7f2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80521-9https://doaj.org/toc/2045-2322Abstract Defibrillation is accomplished by the passage of sufficient current through the heart to terminate ventricular fibrillation (VF). Although current-based defibrillation has been shown to be superior to energy-based defibrillation with monophasic waveforms, defibrillators with biphasic waveforms still use energy as a therapeutic dosage. In the present study, we propose a novel framework of current-based, biphasic defibrillation grounded in transthoracic impedance (TTI) measurements: adjusting the charging voltage to deliver the desired current based on the energy setting and measured pre-shock TTI; and adjusting the pulse duration to deliver the desired energy based on the output current and intra-shock TTI. The defibrillation efficacy of current-based defibrillation was compared with that of energy-based defibrillation in a simulated high impedance rabbit model of VF. Cardiac arrest was induced by pacing the right ventricle for 60 s in 24 New Zealand rabbits (10 males). A defibrillatory shock was applied with one of the two defibrillators after 90 s of VF. The defibrillation thresholds (DFTs) at different pathway impedances were determined utilizing a 5-step up-and-down protocol. The procedure was repeated after an interval of 5 min. A total of 30 fibrillation events and defibrillation attempts were investigated for each animal. The pulse duration was significantly shorter, and the waveform tilt was much lower for the current-based defibrillator. Compared with energy-based defibrillation, the energy, peak voltage, and peak current DFT were markedly lower when the pathway impedance was > 120 Ω, but there were no differences in DFT values when the pathway impedance was between 80 and 120 Ω for current-based defibrillation. Additionally, peak voltage and the peak current DFT were significantly lower for current-based defibrillation when the pathway impedance was < 80 Ω. In sum, a framework of adjusting the charging voltage and shock duration to deliver constant energy for low impedance and constant current for high impedance via pre-shock and intra-shock impedance measurements, greatly improved the defibrillation efficacy of high impedance by lowering the energy DFT.Weiming LiJingru LiLiang WeiJianjie WangLi PengJuan WangChanglin YinYongqin LiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Weiming Li Jingru Li Liang Wei Jianjie Wang Li Peng Juan Wang Changlin Yin Yongqin Li A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
description	Abstract Defibrillation is accomplished by the passage of sufficient current through the heart to terminate ventricular fibrillation (VF). Although current-based defibrillation has been shown to be superior to energy-based defibrillation with monophasic waveforms, defibrillators with biphasic waveforms still use energy as a therapeutic dosage. In the present study, we propose a novel framework of current-based, biphasic defibrillation grounded in transthoracic impedance (TTI) measurements: adjusting the charging voltage to deliver the desired current based on the energy setting and measured pre-shock TTI; and adjusting the pulse duration to deliver the desired energy based on the output current and intra-shock TTI. The defibrillation efficacy of current-based defibrillation was compared with that of energy-based defibrillation in a simulated high impedance rabbit model of VF. Cardiac arrest was induced by pacing the right ventricle for 60 s in 24 New Zealand rabbits (10 males). A defibrillatory shock was applied with one of the two defibrillators after 90 s of VF. The defibrillation thresholds (DFTs) at different pathway impedances were determined utilizing a 5-step up-and-down protocol. The procedure was repeated after an interval of 5 min. A total of 30 fibrillation events and defibrillation attempts were investigated for each animal. The pulse duration was significantly shorter, and the waveform tilt was much lower for the current-based defibrillator. Compared with energy-based defibrillation, the energy, peak voltage, and peak current DFT were markedly lower when the pathway impedance was > 120 Ω, but there were no differences in DFT values when the pathway impedance was between 80 and 120 Ω for current-based defibrillation. Additionally, peak voltage and the peak current DFT were significantly lower for current-based defibrillation when the pathway impedance was < 80 Ω. In sum, a framework of adjusting the charging voltage and shock duration to deliver constant energy for low impedance and constant current for high impedance via pre-shock and intra-shock impedance measurements, greatly improved the defibrillation efficacy of high impedance by lowering the energy DFT.
format	article
author	Weiming Li Jingru Li Liang Wei Jianjie Wang Li Peng Juan Wang Changlin Yin Yongqin Li
author_facet	Weiming Li Jingru Li Liang Wei Jianjie Wang Li Peng Juan Wang Changlin Yin Yongqin Li
author_sort	Weiming Li
title	A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
title_short	A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
title_full	A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
title_fullStr	A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
title_full_unstemmed	A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
title_sort	framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ac94c1f7dd6d4be19a6e68a3b5926f7f
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A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits

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