A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits.
A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits.
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基于电流的除颤框架提高了双相截断指数波形对兔子的除颤功效
DOI：
10.1038/s41598-020-80521-9
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发表时间：
2021-01-15
影响因子：
4.6
通讯作者：
Li Y
中科院分区：
文献类型：
--
作者：
Li W;Li J;Wei L;Wang J;Peng L;Wang J;Yin C;Li Y
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.
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影响因子：
6.5
作者：
Carpenter, J;Rea, TD;Eisenberg, MS
通讯作者：
Eisenberg, MS
影响因子：
6.5
作者：
Hess, Erik P.;Agarwal, Dipti;White, Roger D.
通讯作者：
White, Roger D.
DOI：
10.1111/j.1540-8159.2009.02660.x
发表时间：
2010-07-01
影响因子：
1.8
作者：
Irnich, Werner
通讯作者：
Irnich, Werner
影响因子：
2.8
作者：
Kerber, RE;Kieso, RA;Charbonnier, F
通讯作者：
Charbonnier, F
影响因子：
6.5
作者：
Li, Yongqin;Ristagno, Giuseppe;Tang, Wanchun
通讯作者：
Tang, Wanchun