Do everything in your power.
Current is not the whole story.
Medical teams should never lack the power to save a life. Energy has been proven to best describe the therapeutic dose delivered to the heart.1-5 That’s why LIFEPAK monitor/ defibrillators escalate biphasic energy up to 360J.
Five independently conducted, peer-reviewed cardioversion studies comparing various biphasic waveforms prove that shocks of the same energy provide the same success rates up to 200 joules, even if the level of current is different.
Conversion rates were lower when 200J was repeated for recurrent VF. All were eventually converted with 360J.
Conversion rates increased for VF with each escalating energy dose up to 360J.
Published clinical data strongly points to an association between higher biphasic shock energy (joules) and higher conversion rates for VF/pVT and AF.
Clinical evidence
- A large volume of published data now exists on biphasic defibrillation. It should be referenced when evaluating proven performance.
- The data shows that at the same low energy biphasic shocks, the most widely used defibrillation waveforms (BTE and RBW) have the same conversion rates from 50J to 200J.
- The data also shows that higher energy biphasic waveforms are associated with higher conversion rates for VF/pVT and AF.
- The 2010 and 2015 AHA Guidelines state full energy biphasic 360J is safe for patients.3,7,14-16 High peak current is a primary cause of myocardial injury.17 Biphasic waveforms use as much as 40% less current than monophasic waveforms.
The only randomized, triple-blinded dosing comparison showed higher conversion rate for VF/pVT when escalating to 360J vs. a fixed protocol.
Conversion rate were lower when 200J was repeated for recurrent VF/pVT. All were eventually converted with 360J.
Conversion rate probability increased in a subset of VF/pVT patients who received shocks at each energy dose. 360J had the highest cumulative rate.
Reference
- Alatawi F, et al. Heart Rhythm 2005;2(4):382-87.
- 2 Kim M, et al. Am J Cardiol 2004;94(11):1438-40.
- 3 Neal S, et al. Am J Cardiol 2003;92(7):810-14.
- 4 Deakin C, et al. Circulation 2011;124(21 Suppl):A244.
- 5 Santomauro M, et al. Ital Heart J Suppl. 2004;5(1):36-43.
- 6 Walker R, et al. Resuscitation 2009;80(7):773-7.
- 7 Koster R, et al. Resuscitation. 2008;78:252-257.