Skip to main content
release_alert
Welcome to the new Scholars 3.0! Read about new features and let us know what you think.
cancel

Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks.

Publication ,  Journal Article
Guse, PA; Rollins, DL; Krassowska, W; Wolf, PD; Smith, WM; Ideker, RE
Published in: Pacing and Clinical Electrophysiology : Pace
August 1993

Previous studies have shown that low internal defibrillation thresholds (DFTs) can be attained by using two pairs of electrodes and combining biphasic shocks with sequential timing. The purpose of this two-part study was to test the defibrillation efficacy of two new shock sequences, an interleaved biphasic, and a common phase sequential biphasic, that utilized two pairs of electrodes and were developed from the concept of sequential biphasic shocks. In the first part, defibrillation catheters were placed in the right ventricle and the superior vena cava of six anesthetized pigs. A small patch electrode was placed on the LV apex through a subxiphoid incision and a cutaneous patch was placed on the left thorax. The mean DFT energies for the interleaved biphasic (5.2 +/- 0.4 J) and the common phase sequential biphasic waveforms (5.4 +/- 0.4 J) were substantially less (P < 0.0001) than those for either the sequential monophasic (10.6 +/- 1.0 J) or single biphasic waveforms (9.0 +/- 1.0 J). In the second study, which used nine anesthetized pigs, the importance of phase reversal was demonstrated by the finding that the DFT energy of a common phase sequential biphasic shock (6.2 +/- 0.4 J) was much less than a common phase sequential monophasic shock (17.9 +/- 1.3 J, P < 0.0001); furthermore, the average DFT for four common phase sequential biphasic configurations (5.7 +/- 0.2 J) was much less than for a configuration that was similar except that current flow was not reversed in one phase so that no biphasic effect was present (19.7 +/- 1.2 J). The efficacy of common phase sequential biphasics was comparable to that of sequential biphasics. The effectiveness of sequential biphasics, interleaved biphasics, and common phase sequential biphasics is possibly due to two mechanisms: (A) an increase in the potential gradient during a later phase in regions that were low during the first phase, and (B) the exposure of most of the myocardium to a biphasic shock that reduces the minimum extracellular potential gradient needed to defibrillate.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pacing and Clinical Electrophysiology : Pace

DOI

EISSN

1540-8159

ISSN

0147-8389

Publication Date

August 1993

Volume

16

Issue

8

Start / End Page

1719 / 1734

Related Subject Headings

  • Ventricular Fibrillation
  • Vena Cava, Superior
  • Swine
  • Jugular Veins
  • Heart Ventricles
  • Heart Atria
  • Equipment Design
  • Electrodes, Implanted
  • Electric Countershock
  • Defibrillators, Implantable
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Guse, P. A., Rollins, D. L., Krassowska, W., Wolf, P. D., Smith, W. M., & Ideker, R. E. (1993). Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks. Pacing and Clinical Electrophysiology : Pace, 16(8), 1719–1734. https://doi.org/10.1111/j.1540-8159.1993.tb01043.x
Guse, P. A., D. L. Rollins, W. Krassowska, P. D. Wolf, W. M. Smith, and R. E. Ideker. “Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks.Pacing and Clinical Electrophysiology : Pace 16, no. 8 (August 1993): 1719–34. https://doi.org/10.1111/j.1540-8159.1993.tb01043.x.
Guse PA, Rollins DL, Krassowska W, Wolf PD, Smith WM, Ideker RE. Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks. Pacing and Clinical Electrophysiology : Pace. 1993 Aug;16(8):1719–34.
Guse, P. A., et al. “Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks.Pacing and Clinical Electrophysiology : Pace, vol. 16, no. 8, Aug. 1993, pp. 1719–34. Epmc, doi:10.1111/j.1540-8159.1993.tb01043.x.
Guse PA, Rollins DL, Krassowska W, Wolf PD, Smith WM, Ideker RE. Effective defibrillation in pigs using interleaved and common phase sequential biphasic shocks. Pacing and Clinical Electrophysiology : Pace. 1993 Aug;16(8):1719–1734.

Published In

Pacing and Clinical Electrophysiology : Pace

DOI

EISSN

1540-8159

ISSN

0147-8389

Publication Date

August 1993

Volume

16

Issue

8

Start / End Page

1719 / 1734

Related Subject Headings

  • Ventricular Fibrillation
  • Vena Cava, Superior
  • Swine
  • Jugular Veins
  • Heart Ventricles
  • Heart Atria
  • Equipment Design
  • Electrodes, Implanted
  • Electric Countershock
  • Defibrillators, Implantable