RESEARCH ARTICLE


Simultaneous Comparison of Many Triphasic Defibrillation Waveforms



Ron Davis, Robert Malkin*
Biomedical Engineering at Duke University, Durham, North Carolina, USA


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Creative Commons License
© Davis and Malkin; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Developing World Healthcare Technology Laboratory Duke University Hudson 136, #90281 Durham, NC 27708 USA; Tel: 919-660-8266; Fax: 919-684-4488; E-mail: robert.malkin@duke.edu


Abstract

Biphasic defibrillation waveforms are now accepted as being more effective at terminating ventricular fibrillation (VF) than monophasic waveforms. If two phases are better than one, this naturally leads to the hypothesis that additional phases improve efficacy. This study tests the hypothesis by adding one additional phase. We examined the efficacy of 18 different triphasic waveforms simultaneously.

We tested the rate of recovery, i.e., successful defibrillation, of 21 guinea pigs (820-1,050 g) using triphasic, monophasic and biphasic defibrillation waveforms. The biphasic and monophasic were control waveforms. VF was electrically induced twenty times per animal and a single defibrillation attempt was made using a test waveform VF episode. Every waveform was adjusted to the energy required to defibrillate that animal 50% of the time, using a biphasic waveform as a control. The success rate of each triphasic waveform was pair-wise compared to the biphasic and monophasic control using the adjusted McNemar statistical test.

Of the 18 triphasic waveforms tested, two were significantly poorer than the monophasic control (p<0.05). One was superior to the biphasic waveform (p<0.1), but not statistically so. We concluded that, while adding a phase to a monophasic waveform does improve efficacy, adding an additional phase to a biphasic waveform does not necessarily improve efficacy.

Keywords: Triphasic waveforms, defibrillation efficacy, defibrillation waveforms, defibrillators..