Changes in transthoracic impedance during sequential biphasic defibrillation.

Introduction: Sequential monophasic defibrillation reduces transthoracic impedance (TTI) and progressively increases current flow for any given energy level. The effect of sequential biphasic shocks on TTI is unknown. We therefore studied patients undergoing elective cardioversion using a biphasic waveform to establish whether this is a phenomenon seen in the clinical setting.

A randomised controlled trial of the effect of biphasic or monophasic waveform on the incidence and severity of cutaneous burns following external direct current cardioversion.

Objective: Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion. We designed a prospective randomised double-blinded controlled study to determine the effect of biphasic or monophasic waveform on the pain and inflammation occurring after elective cardioversion.

Materials And Methods: One hundred and thirty nine patients undergoing elective DC cardioversion were randomised to receive monophasic (HP Codemaster XL; 100, 200, 300, 360, and 360 J) or biphasic (Welch Allyn-MRL PIC defibrillator; 70, 100, 150, 200, and 300 J) waveforms.

A randomized controlled trial of efficacy and ST change following use of the Welch-Allyn MRL PIC biphasic waveform versus damped sine monophasic waveform for external DC cardioversion.

Objective: Biphasic waveforms have similar or greater efficacy at cardioverting atrial and ventricular arrhythmias at lower energy levels than monophasic waveforms, and cause less ST depression following defibrillation of ventricular fibrillation. No studies have investigated this effect on ST change with atrial arrhythmias. We studied the efficacy of the Welch Allyn-MRL PIC biphasic defibrillator.

Post-shock myocardial stunning: a prospective randomised double-blind comparison of monophasic and biphasic waveforms.

Introduction: Compared with monophasic defibrillation, biphasic defibrillation is associated with less myocardial stunning and earlier activation of sodium channels. We therefore hypothesised that earlier sodium channel activation would result in earlier restoration of the first sinus beat following elective DC cardioversion.

Methods: Adults undergoing elective DC cardioversion were randomised to receive either monophasic or biphasic escalating transthoracic shocks.

The effect of prophylactic topical steroid cream on the incidence and severity of cutaneous burns following external DC cardioversion.

Introduction: Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion. We designed a prospective double-blinded controlled study to determine whether the application of steroid cream prior to cardioversion reduces their incidence and severity.

Materials And Methods: Two hours before elective DC cardioversion, we applied betamethasone 0.

The effect of topical non-steroidal anti-inflammatory cream on the incidence and severity of cutaneous burns following external DC cardioversion.

Introduction: Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion. We designed a study to determine whether the application of non-steroidal anti-inflammatory cream prior to cardioversion reduces their incidence and severity.

Materials And Methods: Two hours before elective DC cardioversion, we randomised 55 patients to receive ibuprofen 5% cream or placebo cream over sternal and apical pad sites, with patients acting as their own controls.

The incidence and severity of cutaneous burns following external DC cardioversion.

Introduction: Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion, but the incidence and severity have never been quantified.

Materials And Methods: Two hours after elective DC cardioversion in 83 sequential patients, we measured skin temperature, erythema index, and minimum sensory and pain detection thresholds at paddle sites and control sites on the contralateral side. Visual analogue pain score (VAS) was recorded at 2 and 24h post-cardioversion.