Dynamics of Variation in Resistance of Chest Exposed to Gurvich–Venin Bipolar Defibrillation Pulse

Vostrikov, V. A.; Gorbunov, B. B.; Гусев, А. Н.; Gusev, Denis; Itkin, G. P.; Konysheva, E. G.; Mamekin, K. A.; Нестеренко, И. В.; Petukhova, M. N.; Селищев, С. В.; Telyshev, D. V.; Trukhmanov, S. B.

doi:10.1007/s10527-010-9139-z

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“…At the same time, the first phase of the uneven (stepped) quasi-sinusoidal biphasic pulse (Figure 3) that we studied earlier, has the lowest threshold energy ratio −229.6 μA 2 •ms/cm 4 (the relative threshold energy being 0.95) [12]. Noteworthy is the fact that during external defibrillation the threshold sloped pulse energy is decreased through reduced resistance of the chest, which was recorded during the pulse current surge [13].…”

Section: Resultsmentioning

confidence: 63%

“…There are objective prerequisites for this. During the experiments on animals [13] [19] [20], ventricular fibrillation was caused by using alternating current with a frequency of 50 Hz (the voltage being ~40 V), which was passed through the external defibrillator electrodes for 2 seconds. Thus, the amplitude of the current passing through the chest and equal to several tens of milliamps, caused excitation of some cardiomyocytes and occurrence of a parasitic self-oscillating wave in ventricular fibrillation.…”

Section: Discussionmentioning

confidence: 99%

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Construction of Energy-Optimal Smooth Monophasic Defibrillation Pulse Waveforms Using Cardiomyocyte Membrane Model

Vostrikov¹,

Gorbunov²,

Селищев³

2015

JBiSE

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The goal is to help create smooth energy-optimal monophasic pulse waveforms for defibrillation using the Luo-Rudy cardiomyocyte membrane computer model. The waveforms were described with the help of the piecewise linear function. Each line segment provides a transition from one present level of the transmembrane potential to the next with a minimal energy value. The duration of the last segment was defined as a minimum duration at which an action potential occurs. Monophasic waveforms of segments 3, 10 and 29 were built using different increments of the transmembrane potential. The pulse energy efficiency was evaluated according to their threshold energy ratios in mA 2 •ms/cm 4 . There was virtually no difference between the threshold energy ratios of the three waveforms constructed and those of the previously studied energy-optimal halfsine waveform: 241 -242 and 243 mA 2 •ms/cm 4 . The pulse waveform constructed is characterized by a low rise and fall as the duration of the rise is ~1.5 times longer than that of the fall. Conclusion: Energy-optimal smooth monophasic pulse waveforms have the same threshold energy ratio as the optimal half-sine one which was studied before. The latter is equivalent to the first phase of biphasic quasi-sinusoidal Gurvich-Venin pulse which has been used in Russia since 1972. Thus, the use of the Luo-Rudy cardiomyocyte membrane model appears to offer no possibilities for a substantial increase in the energy efficiency (threshold energy ratio reduction) of the classical monophasic defibrillation pulse waveforms.

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Section: Resultsmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%