Evaluation of a Unique Defibrillation Unit with Dual-Vector Biphasic Waveform Capabilities

Towards a Miniaturized Defibrillator

Hideo Okamura, Christopher V. Desimone, Ammar M. Killu, Emily J. Gilles, Jason Tri, Roshini Asirvatham, Dejae J. Ladewig, Scott H. Suddendorf, Joanne M. Powers, Christina M. Wood-Wentz, Peter D. Gray, Douglas M. Raymond, Shelley J. Savage, Walter T. Savage, Charles J Bruce, Samuel J Asirvatham, Paul Andrew Friedman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Automated external defibrillators can provide life-saving therapies to treat ventricular fibrillation. We developed a prototype unit that can deliver a unique shock waveform produced by four independent capacitors that is delivered through two shock vectors, with the rationale of providing more robust shock pathways during emergent defibrillation. We describe the initial testing and feasibility of this unique defibrillation unit, features of which may enable downsizing of current defibrillator devices. Methods: We tested our defibrillation unit in four large animal models (two canine and two swine) under general anesthesia. Experimental defibrillation thresholds (DFT) were obtained by delivery of a unique waveform shock pulse via a dual-vector pathway with four defibrillation pads (placed across the chest). DFTs were measured and compared with those of a commercially available biphasic defibrillator (Zoll M series, Zoll Medical, Chelmsford, MA, USA) tested in two different vectors. Shocks were delivered after 10 seconds of stable ventricular fibrillation and the output characteristics and shock outcome recorded. Each defibrillation series used a step-down to failure protocol to define the defibrillation threshold. Results: A total of 96 shocks were delivered during ventricular fibrillation in four large animals. In comparison to the Zoll M series, which delivered a single-vector, biphasic shock, the energy required for successful defibrillation using the unique dual-vector biphasic waveform did not differ significantly (P = 0.65). Conclusions: Our early findings support the feasibility of a unique external defibrillation unit using a dual-vector biphasic waveform approach. This warrants further study to leverage this unique concept and work toward a miniaturized, portable shock delivery system.

Original languageEnglish (US)
Pages (from-to)108-114
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume40
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Defibrillators
Shock
Ventricular Fibrillation
General Anesthesia
Canidae
Swine
Thorax
Animal Models
Equipment and Supplies

Keywords

  • defibrillator
  • dual-vector biphasic shock waveform
  • miniaturized

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of a Unique Defibrillation Unit with Dual-Vector Biphasic Waveform Capabilities : Towards a Miniaturized Defibrillator. / Okamura, Hideo; Desimone, Christopher V.; Killu, Ammar M.; Gilles, Emily J.; Tri, Jason; Asirvatham, Roshini; Ladewig, Dejae J.; Suddendorf, Scott H.; Powers, Joanne M.; Wood-Wentz, Christina M.; Gray, Peter D.; Raymond, Douglas M.; Savage, Shelley J.; Savage, Walter T.; Bruce, Charles J; Asirvatham, Samuel J; Friedman, Paul Andrew.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 40, No. 2, 01.02.2017, p. 108-114.

Research output: Contribution to journalArticle

Okamura, H, Desimone, CV, Killu, AM, Gilles, EJ, Tri, J, Asirvatham, R, Ladewig, DJ, Suddendorf, SH, Powers, JM, Wood-Wentz, CM, Gray, PD, Raymond, DM, Savage, SJ, Savage, WT, Bruce, CJ, Asirvatham, SJ & Friedman, PA 2017, 'Evaluation of a Unique Defibrillation Unit with Dual-Vector Biphasic Waveform Capabilities: Towards a Miniaturized Defibrillator', PACE - Pacing and Clinical Electrophysiology, vol. 40, no. 2, pp. 108-114. https://doi.org/10.1111/pace.12979
Okamura, Hideo ; Desimone, Christopher V. ; Killu, Ammar M. ; Gilles, Emily J. ; Tri, Jason ; Asirvatham, Roshini ; Ladewig, Dejae J. ; Suddendorf, Scott H. ; Powers, Joanne M. ; Wood-Wentz, Christina M. ; Gray, Peter D. ; Raymond, Douglas M. ; Savage, Shelley J. ; Savage, Walter T. ; Bruce, Charles J ; Asirvatham, Samuel J ; Friedman, Paul Andrew. / Evaluation of a Unique Defibrillation Unit with Dual-Vector Biphasic Waveform Capabilities : Towards a Miniaturized Defibrillator. In: PACE - Pacing and Clinical Electrophysiology. 2017 ; Vol. 40, No. 2. pp. 108-114.
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N2 - Background: Automated external defibrillators can provide life-saving therapies to treat ventricular fibrillation. We developed a prototype unit that can deliver a unique shock waveform produced by four independent capacitors that is delivered through two shock vectors, with the rationale of providing more robust shock pathways during emergent defibrillation. We describe the initial testing and feasibility of this unique defibrillation unit, features of which may enable downsizing of current defibrillator devices. Methods: We tested our defibrillation unit in four large animal models (two canine and two swine) under general anesthesia. Experimental defibrillation thresholds (DFT) were obtained by delivery of a unique waveform shock pulse via a dual-vector pathway with four defibrillation pads (placed across the chest). DFTs were measured and compared with those of a commercially available biphasic defibrillator (Zoll M series, Zoll Medical, Chelmsford, MA, USA) tested in two different vectors. Shocks were delivered after 10 seconds of stable ventricular fibrillation and the output characteristics and shock outcome recorded. Each defibrillation series used a step-down to failure protocol to define the defibrillation threshold. Results: A total of 96 shocks were delivered during ventricular fibrillation in four large animals. In comparison to the Zoll M series, which delivered a single-vector, biphasic shock, the energy required for successful defibrillation using the unique dual-vector biphasic waveform did not differ significantly (P = 0.65). Conclusions: Our early findings support the feasibility of a unique external defibrillation unit using a dual-vector biphasic waveform approach. This warrants further study to leverage this unique concept and work toward a miniaturized, portable shock delivery system.

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