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Novel rectangular biphasic and monophasic waveforms delivered by a radiofrequency-powered defibrillator compared with conventional capacitor-based waveforms in transvenous cardioversion of atrial fibrillation

Biomedical Sciences Research Institute Computer Science Research Institute Environmental Sciences Research Institute Nanotechnology & Advanced Materials Research Institute

Walsh, SJ, Manoharan, G, Escalona, OJ, Santos, JA, Evans, N, Anderson, JMCC, Stevenson, M, Allen, JD and Adgey, AAJ (2006) Novel rectangular biphasic and monophasic waveforms delivered by a radiofrequency-powered defibrillator compared with conventional capacitor-based waveforms in transvenous cardioversion of atrial fibrillation. Europace, 8 . pp. 873-880. [Journal article]

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Abstract

Aims: To investigate the feasibility and efficacy of novel low-tilt biphasic waveforms in transvenouscardioversion of atrial fibrillation (AF), delivered by a radiofrequency-powered defibrillator.Methods and results: The investigation was performed in three phases in an animal model of AF: a feasibility and efficacy study (in 10 adult Large White Landrace swine), comparison with low-tilt monophasic and standard capacitor-based waveforms, and an assessment of sequential shocks delivered over several pathways (in 15 adult Suffolk sheep). Defibrillation electrodes were positioned transvenously under fluoroscopic control in the high lateral right atrium and distal coronary sinus. When multiple defibrillation pathways were tested, a third electrode was also attached to the lower interatrial septum. The electrodes were then connected to a radiofrequency (RF)-powered defibrillator or a standard defibrillator. After confirmation of successful induction of sustained AF, defibrillation was attempted. Percentage success was calculated from the effects of all shocks delivered to all the animals within each set of experiments. Of the low-tilt (RF) biphasic waveforms delivered during internal atrial cardioversion, 100% success was achieved with a 6/6 ms 100/250 V waveform (1.45+/-0.01 J). This waveform was similar in efficacy to low-tilt (RF) monophasic waveforms (88 vs. 92% success, 1.58+/-0.01 vs. 2.67+/-0.03 J; P = NS; delivered energy 41% lower) and superior to equivalent voltage standard monophasic (50% success, 0.67+/-0.00 J; P < 0.001) and biphasic waveforms (72% success, 0.69+/-0.00 J; P = 0.03). Sequential shocks delivered over dual pathways did not improve the efficacy of low-tilt biphasic waveforms.Conclusion: A low-tilt biphasic waveform from a RF-powered defibrillator (6/6 ms, 100/250 V) ismore efficacious than standard monophasic or biphasic waveforms (equivalent voltage) and is similar in efficacy to low-tilt monophasic waveforms.

Item Type:Journal article
Keywords:Atrial Fibrillation, Cardioversion, Implantable Defibrillator, RF Defibrillation, Biphasic Waveform, AF, ECG, Cardiology.
Faculties and Schools:Faculty of Computing & Engineering
Faculty of Computing & Engineering > School of Computing and Intelligent Systems
Faculty of Computing & Engineering > School of Engineering
Research Institutes and Groups:Engineering Research Institute
Engineering Research Institute > Nanotechnology & Integrated BioEngineering Centre (NIBEC)
ID Code:8665
Deposited By:Professor Omar Escalona
Deposited On:06 Sep 2011 15:39
Last Modified:06 Sep 2011 15:39

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