Transmembrane potential changes caused by monophasic and biphasic shocks

被引:7
|
作者
Zhou, XH [1 ]
Smith, WM [1 ]
Justice, RK [1 ]
Wayland, JL [1 ]
Ideker, RE [1 ]
机构
[1] Univ Alabama, Dept Med, Div Cardiovasc Dis, Birmingham, AL 35294 USA
关键词
depolarization; hyperpolarization; action potential duration; defibrillation;
D O I
10.1152/ajpheart.1998.275.5.H1798
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Transmembrane potential change (Delta V-m) during shocks was recorded by a double-barrel microelectrode in 12 isolated guinea pig papillary muscles. After 10 S1 stimuli, square-wave S2 shocks of both polarities were given consisting of 10-ms monophasic and 10/10-ms and 5/5-ms biphasic waveforms that created potential gradients from 1.1 +/- 0.3 to 11.9 +/- 0.4 V/cm. S2 shocks were applied with 30, 60- to 70-, and 90- to 130-ms S1-S2 coupling intervals so that they occurred during the plateau, late portion of the plateau, and phase 3 of the action potential, respectively. Some shocks were given across as well as along the fiber orientation. The shocks caused hyperpolarization with one polarity and depolarization with the opposite polarity. The ratio of the magnitude of hyperpolarization to that of depolarization at the three S1-S2 coupling intervals was 1.5 +/- 0.3, 1.1 +/- 0.2, and 0.5 +/- 0.2, respectively. Delta V-m, during the shock was significantly greater for the monophasic than for the two biphasic shocks. The prolongation of total repolarizing time (TRT) was significantly greater for monophasic (119.8 +/- 19.1%) and 10/10-ms biphasic (120.5 +/- 18.2%) than for 5/5-ms biphasic (113.0 +/- 12.9%) waveforms. The dispersion of the normalized TRT between instances of hyperpolarization and depolarization caused by the two shock polarities was 7.4 +/- 7.1% for monophasic, 3.0 +/- 4.1% for 10/10-ms biphasic, and 2.8 +/- 3.1% for 5/5-ms biphasic shocks (P < 0.05 for monophasic vs. biphasic), Shock fields along fibers produced a larger Delta V-m and prolongation of TRT than those across fibers. We conclude that 1) a change in shock polarity causes an asymmetrical change in membrane polarization depending on shock timing; 2) the 5/5-ms biphasic waveform causes the smallest Delta V-m, prolongs repolarization the least, and causes the smallest polarity-dependent dispersion; and 3) the changes in transmembrane potential and repolarization are influenced by fiber orientation.
引用
收藏
页码:H1798 / H1807
页数:10
相关论文
共 50 条
  • [31] The role of calcium current in the nonlinear changes of transmembrane potential during defibrillation shocks
    Cheek, ER
    Ideker, RE
    Fast, VG
    CIRCULATION, 2000, 102 (18) : 340 - 340
  • [32] Nonlinear changes of transmembrane potential during electrical shocks - Role of membrane electroporation
    Cheek, ER
    Fast, VG
    CIRCULATION RESEARCH, 2004, 94 (02) : 208 - 214
  • [33] The influence of sodium channel blockade on the defibrillation energy requirements of biphasic versus monophasic shocks
    Nelson, SD
    Lenhart, MB
    Saffarin, A
    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1996, 19 (11): : 1568 - 1573
  • [34] A randomized trial comparing monophasic and biphasic waveform shocks for external cardioversion of atrial fibrillation
    Koster, RW
    Dorian, P
    Chapman, FW
    Schmitt, PW
    O'Grady, SG
    Walker, RG
    AMERICAN HEART JOURNAL, 2004, 147 (05) : e1 - e7
  • [35] COMPARISON OF MONOPHASIC AND BIPHASIC SHOCKS IN CARDIOVERSION OF VENTRICULAR-TACHYCARDIA IN THE CANINE INFARCT MODEL
    CALLIHAN, RL
    WALCOTT, GP
    SMITH, WM
    IDEKER, RE
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1994, : A208 - A208
  • [36] COMPARATIVE EFFICACY OF MONOPHASIC AND BIPHASIC TRUNCATED EXPONENTIAL SHOCKS FOR NONTHORACOTOMY INTERNAL DEFIBRILLATION IN DOGS
    CHAPMAN, PD
    VETTER, JW
    SOUZA, JJ
    TROUP, PJ
    WETHERBEE, JN
    HOFFMANN, RG
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 12 (03) : 739 - 745
  • [37] Direct defibrillation during cardiothoracic surgery is more effective with biphasic shocks than monophasic damped sine wave shocks
    Tacker, W
    Lazzara, R
    Bowdle, A
    Aldea, G
    Schmitt, P
    O'Grady, S
    Schwarz, B
    Mair, P
    Lindner, K
    EUROPEAN HEART JOURNAL, 2001, 22 : 89 - 89
  • [38] Monophasic or biphasic defibrillation
    Boyd, R
    Ghosh, A
    EMERGENCY MEDICINE JOURNAL, 2001, 18 (02) : 122 - 122
  • [39] Mechanism of action potential prolongation by biphasic shocks
    Zhou, XH
    Smith, WM
    Justice, RK
    Ideker, RE
    CIRCULATION, 1997, 96 (08) : 3555 - 3555
  • [40] Biphasic shocks compared with monophasic damped sine wave shocks for direct ventricular defibrillation during open heart surgery
    Schwarz, B
    Bowdle, TA
    Jett, GK
    Mair, P
    Lindner, KH
    Aldea, GS
    Lazzara, RG
    O'Grady, SG
    Schmitt, PW
    Walker, RG
    Chapman, FW
    Tacker, WA
    ANESTHESIOLOGY, 2003, 98 (05) : 1063 - 1069