Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing

BJ Kidwai, JD Allen, MT Harbinson, A McIntyre, JMCC Anderson, AAJ Adgey

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    The aim of this study was to compare the efficacy of internal atrial defibrillation by conventional truncated exponential biphasic waveforms with and without waveform rounding (1-2 phases) and to determine optimal duration for this novel double rounded waveform. Atrial fibrillation, induced by rapid electrical stimulation, was converted by internal shocks through defibrillation catheters (lateral right atrium and coronary sinus) in anesthetised sheep. Rounding the leading edges of the conventional biphasic waveform (Ventritex HVS-02; settings 100/-50 V, 150/-70 V, and 200/-100 V; n = 8) reduced delivered peak and trough voltages, currents, and energy (by > or = 21 %, P < 0.001; for double (both phases) rounded) without decreasing cardioversion success. At 100/-50 V the efficacy of single (first phase) rounded (53 +/- 13%; mean +/- SEM) and double rounded (59 +/- 11%) shocks was similar to the conventional waveform (56 +/- 14%). Double rounded waveform (phase durations 1-20 ms) efficacy was optimum at 6-10 ms phase duration (100% success at 10-ms phase duration; 1.52 +/- 0.04 J delivered energy; n = 6). Successful cardioversion by conventional, single rounded, and double rounded biphasic waveforms (duration 6 ms each phase), conventional monophasic, rounded monophasic (duration 12 ms), and a damped sine waveform correlated strongly with peak-to-trough voltage swing within the waveform (r = 0.882; P < 0.01; n = 8). For internal atrial defibrillation, rounding both phases of the conventional biphasic waveforms, the double rounded waveform, permits similar efficacy to the conventional truncated exponential biphasic waveform at reduced peak voltage, current, and delivered energy. Optimum phase duration is 6-10 ms (tested range 1-20 ms).
    LanguageEnglish
    Pages1198-1207
    JournalPacing and Clinical Electrophysiology : PACE
    Volume24
    Issue number8 Pt 1
    Publication statusPublished - 2001

    Fingerprint

    Electric Countershock
    Shock
    Coronary Sinus
    Heart Atria
    Atrial Fibrillation
    Electric Stimulation
    Sheep
    Catheters

    Keywords

    • Animals
    • Atrial Fibrillation: therapy
    • Catheterization: instrumentation
    • Defibrillators
    • Implantable
    • Disease Models
    • Animal
    • Electric Countershock: methods
    • Electric Stimulation
    • Electrodes
    • Sheep

    Cite this

    Kidwai, BJ., Allen, JD., Harbinson, MT., McIntyre, A., Anderson, JMCC., & Adgey, AAJ. (2001). Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing. Pacing and Clinical Electrophysiology : PACE, 24(8 Pt 1), 1198-1207.
    Kidwai, BJ ; Allen, JD ; Harbinson, MT ; McIntyre, A ; Anderson, JMCC ; Adgey, AAJ. / Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing. In: Pacing and Clinical Electrophysiology : PACE. 2001 ; Vol. 24, No. 8 Pt 1. pp. 1198-1207.
    @article{d39b864b42dc458e9e0220b5e1e314e3,
    title = "Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing",
    abstract = "The aim of this study was to compare the efficacy of internal atrial defibrillation by conventional truncated exponential biphasic waveforms with and without waveform rounding (1-2 phases) and to determine optimal duration for this novel double rounded waveform. Atrial fibrillation, induced by rapid electrical stimulation, was converted by internal shocks through defibrillation catheters (lateral right atrium and coronary sinus) in anesthetised sheep. Rounding the leading edges of the conventional biphasic waveform (Ventritex HVS-02; settings 100/-50 V, 150/-70 V, and 200/-100 V; n = 8) reduced delivered peak and trough voltages, currents, and energy (by > or = 21 {\%}, P < 0.001; for double (both phases) rounded) without decreasing cardioversion success. At 100/-50 V the efficacy of single (first phase) rounded (53 +/- 13{\%}; mean +/- SEM) and double rounded (59 +/- 11{\%}) shocks was similar to the conventional waveform (56 +/- 14{\%}). Double rounded waveform (phase durations 1-20 ms) efficacy was optimum at 6-10 ms phase duration (100{\%} success at 10-ms phase duration; 1.52 +/- 0.04 J delivered energy; n = 6). Successful cardioversion by conventional, single rounded, and double rounded biphasic waveforms (duration 6 ms each phase), conventional monophasic, rounded monophasic (duration 12 ms), and a damped sine waveform correlated strongly with peak-to-trough voltage swing within the waveform (r = 0.882; P < 0.01; n = 8). For internal atrial defibrillation, rounding both phases of the conventional biphasic waveforms, the double rounded waveform, permits similar efficacy to the conventional truncated exponential biphasic waveform at reduced peak voltage, current, and delivered energy. Optimum phase duration is 6-10 ms (tested range 1-20 ms).",
    keywords = "Animals, Atrial Fibrillation: therapy, Catheterization: instrumentation, Defibrillators, Implantable, Disease Models, Animal, Electric Countershock: methods, Electric Stimulation, Electrodes, Sheep",
    author = "BJ Kidwai and JD Allen and MT Harbinson and A McIntyre and JMCC Anderson and AAJ Adgey",
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    Kidwai, BJ, Allen, JD, Harbinson, MT, McIntyre, A, Anderson, JMCC & Adgey, AAJ 2001, 'Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing', Pacing and Clinical Electrophysiology : PACE, vol. 24, no. 8 Pt 1, pp. 1198-1207.

    Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing. / Kidwai, BJ; Allen, JD; Harbinson, MT; McIntyre, A; Anderson, JMCC; Adgey, AAJ.

    In: Pacing and Clinical Electrophysiology : PACE, Vol. 24, No. 8 Pt 1, 2001, p. 1198-1207.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing

    AU - Kidwai, BJ

    AU - Allen, JD

    AU - Harbinson, MT

    AU - McIntyre, A

    AU - Anderson, JMCC

    AU - Adgey, AAJ

    N1 - LR: 20061115RX: 850816 (on Jul 22, 2011)

    PY - 2001

    Y1 - 2001

    N2 - The aim of this study was to compare the efficacy of internal atrial defibrillation by conventional truncated exponential biphasic waveforms with and without waveform rounding (1-2 phases) and to determine optimal duration for this novel double rounded waveform. Atrial fibrillation, induced by rapid electrical stimulation, was converted by internal shocks through defibrillation catheters (lateral right atrium and coronary sinus) in anesthetised sheep. Rounding the leading edges of the conventional biphasic waveform (Ventritex HVS-02; settings 100/-50 V, 150/-70 V, and 200/-100 V; n = 8) reduced delivered peak and trough voltages, currents, and energy (by > or = 21 %, P < 0.001; for double (both phases) rounded) without decreasing cardioversion success. At 100/-50 V the efficacy of single (first phase) rounded (53 +/- 13%; mean +/- SEM) and double rounded (59 +/- 11%) shocks was similar to the conventional waveform (56 +/- 14%). Double rounded waveform (phase durations 1-20 ms) efficacy was optimum at 6-10 ms phase duration (100% success at 10-ms phase duration; 1.52 +/- 0.04 J delivered energy; n = 6). Successful cardioversion by conventional, single rounded, and double rounded biphasic waveforms (duration 6 ms each phase), conventional monophasic, rounded monophasic (duration 12 ms), and a damped sine waveform correlated strongly with peak-to-trough voltage swing within the waveform (r = 0.882; P < 0.01; n = 8). For internal atrial defibrillation, rounding both phases of the conventional biphasic waveforms, the double rounded waveform, permits similar efficacy to the conventional truncated exponential biphasic waveform at reduced peak voltage, current, and delivered energy. Optimum phase duration is 6-10 ms (tested range 1-20 ms).

    AB - The aim of this study was to compare the efficacy of internal atrial defibrillation by conventional truncated exponential biphasic waveforms with and without waveform rounding (1-2 phases) and to determine optimal duration for this novel double rounded waveform. Atrial fibrillation, induced by rapid electrical stimulation, was converted by internal shocks through defibrillation catheters (lateral right atrium and coronary sinus) in anesthetised sheep. Rounding the leading edges of the conventional biphasic waveform (Ventritex HVS-02; settings 100/-50 V, 150/-70 V, and 200/-100 V; n = 8) reduced delivered peak and trough voltages, currents, and energy (by > or = 21 %, P < 0.001; for double (both phases) rounded) without decreasing cardioversion success. At 100/-50 V the efficacy of single (first phase) rounded (53 +/- 13%; mean +/- SEM) and double rounded (59 +/- 11%) shocks was similar to the conventional waveform (56 +/- 14%). Double rounded waveform (phase durations 1-20 ms) efficacy was optimum at 6-10 ms phase duration (100% success at 10-ms phase duration; 1.52 +/- 0.04 J delivered energy; n = 6). Successful cardioversion by conventional, single rounded, and double rounded biphasic waveforms (duration 6 ms each phase), conventional monophasic, rounded monophasic (duration 12 ms), and a damped sine waveform correlated strongly with peak-to-trough voltage swing within the waveform (r = 0.882; P < 0.01; n = 8). For internal atrial defibrillation, rounding both phases of the conventional biphasic waveforms, the double rounded waveform, permits similar efficacy to the conventional truncated exponential biphasic waveform at reduced peak voltage, current, and delivered energy. Optimum phase duration is 6-10 ms (tested range 1-20 ms).

    KW - Animals

    KW - Atrial Fibrillation: therapy

    KW - Catheterization: instrumentation

    KW - Defibrillators

    KW - Implantable

    KW - Disease Models

    KW - Animal

    KW - Electric Countershock: methods

    KW - Electric Stimulation

    KW - Electrodes

    KW - Sheep

    M3 - Article

    VL - 24

    SP - 1198

    EP - 1207

    JO - Pace-Pacing and Clinical Electrophysiology

    T2 - Pace-Pacing and Clinical Electrophysiology

    JF - Pace-Pacing and Clinical Electrophysiology

    SN - 0147-8389

    IS - 8 Pt 1

    ER -