Low-Energy Biphasic Waveform Defibrillation: Evidence-Based Review Applied to Emergency Cardiovascular Care Guidelines

Energy levels for biphasic defibrillation.

Defibrillators which deliver biphasic waveforms are rapidly replacing defibrillators which deliver monophasic waveforms. Lower energy biphasic shocks cause less myocardial injury and subsequent post-resuscitation myocardial dysfunction thus potential improving the likelihood of survival.(1-4) Recommendations of the International Liaison Committee on Resuscitation (ILCOR) state that biphasic ene...

Emergency cardiovascular care guidelines 2005.

Electrode system influence on biphasic waveform defibrillation efficacy in humans.

BACKGROUND Several clinical studies have demonstrated a general superiority of biphasic waveform defibrillation compared with monophasic waveform defibrillation using epicardial lead systems. To test the breadth of utility of biphasic waveforms in humans, a prospective, randomized evaluation of defibrillation efficacy of monophasic and single capacitor biphasic waveform pulses was performed for...

Ascending-ramp biphasic waveform has a lower defibrillation threshold and releases less troponin I than a truncated exponential biphasic waveform.

BACKGROUND We tested the hypothesis that the shape of the shock waveform affects not only the defibrillation threshold but also the amount of cardiac damage. METHODS AND RESULTS Defibrillation thresholds were determined for 11 waveforms-3 ascending-ramp waveforms, 3 descending-ramp waveforms, 3 rectilinear first-phase biphasic waveforms, a Gurvich waveform, and a truncated exponential biphasi...

Transthoracic incremental monophasic versus biphasic defibrillation by emergency responders (TIMBER): a randomized comparison of monophasic with biphasic waveform ascending energy defibrillation for the resuscitation of out-of-hospital cardiac arrest due to ventricular fibrillation.

BACKGROUND Although biphasic, as compared with monophasic, waveform defibrillation for cardiac arrest is increasing in use and popularity, whether it is truly a more lifesaving waveform is unproven. METHODS AND RESULTS Consecutive adults with nontraumatic out-of-hospital ventricular fibrillation cardiac arrest were randomly allocated to defibrillation according to the waveform from automated ...