Optimal truncation of defibrillation pulses.
The statement that the optimal pulse for defi- brillation has not yet been discovered implies that an ideal pulse exists, but that it is different in shape, duration, and energy as compared to pulses of today. The optimum pulse is that which can defibrillate with lowest energy, Reduction of energy c...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 18; no. 4; pp. 673 - 689 |
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| Autor principal: | |
| Formato: | Journal Article |
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Wiley-Blackwell
Apr1995
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106038456&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106038456 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Apr1995 vid: 18 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106038456 2009414555 NLM7596851 106038456 ppf: 673 ppct: 16 formats: fmt: @attributes: type: P tig: atl: Optimal truncation of defibrillation pulses. aug: au: Irnich W sug: ab: The statement that the optimal pulse for defi- brillation has not yet been discovered implies that an ideal pulse exists, but that it is different in shape, duration, and energy as compared to pulses of today. The optimum pulse is that which can defibrillate with lowest energy, Reduction of energy can be reached twofold: by looking for a pulse duration with lowest energy threshold, and by finding the optimal truncation with lowest re fibrillating effect. Assuming that there is also a rheobase in defibrillation below which no defibrillating but probably a refibrillating effect exists, the exponential pulse should be truncated if it intersects with the rheobase. Combining the fundamental law of electrostimulation with this boundary condition allows for the mathematical solution of the above problem of optimal energy. Defibrillation can be optimized with respect to pulse duration or tilt and to energy efficiency. The most important parameter in determining other optimized parameters such as output capacitor is the chronaxie. The calculations reveal that the 'concept of constant energy' does not accurately describe defibrillation, that today's implantable cardioverter defibrillator devices possess refibrillating tilts, that pulse durations should be programmed to values between 4 and 10 msec, and that smaller output capacitors around 30 [mu]F would minimize the energy requirements. Whether optimized monophasic pulses are inferior or equal to biphasic pulses needs further experimental studies. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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