monophasic with biphasic defibrillation

Q: Why biphasic cardioversion is preferred over monophasic cardioversion?

Answer:

In monophasic cardioversion, the current travels only in one direction - from one paddle to the other.

In biphasic cardioversion, the current travels towards the positive paddle, reverses, and returns several times, delivering one cycle every ten milliseconds. They are associated with fewer burns, less myocardial damage, and higher first-shock success.

#hemodynamics

#Code-blue

#resuscitation

References:

1. Higgins SL, Herre JM, Epstein AE, Greer GS, Friedman PL, Gleva ML, Porterfield JG, Chapman FW, Finkel ES, Schmitt PW, Nova RC, Greene HL. A comparison of biphasic and monophasic shocks for external defibrillation. Physio-Control Biphasic Investigators. Prehosp Emerg Care. 2000 Oct-Dec;4(4):305-13. doi: 10.1080/10903120090941001. Erratum in: Prehosp Emerg Care 2001 Jan-Mar;5(1):78. PMID: 11045408.

2. Kudenchuk PJ, Cobb LA, Copass MK, Olsufka M, Maynard C, Nichol G. Transthoracic incremental monophasic versus biphasic defibrillation by emergency responders (TIMBER): a randomized comparison of monophasic with biphasic waveform ascending energy defibrillation for the resuscitation of out-of-hospital cardiac arrest due to ventricular fibrillation. Circulation. 2006 Nov 7;114(19):2010-8. doi: 10.1161/CIRCULATIONAHA.106.636506. Epub 2006 Oct 23. PMID: 17060379.