Defibrillator is a device used to shock the heart back into action when it stops contracting due to a disorder of the rhythm known as ventricular fibrillation (VF). The electrodes used to deliver the shock could be either defibrillator paddles or patches, directly applied to the chest below the left collar bone and at the apex of the heart.
The direct current shock given can have a monophasic or biphasic wave form. In monophasic shock, the shock is given in only one direction from one electrode to the other. In a biphasic shock, initially direction of shock is reversed by changing the polarity of the electrodes in the latter part of the shock being delivered. Usually the initial voltage applied is higher than the reversed polarity shock. Biphasic wave forms were initially developed for use in implantable cardioverter defibrillators (ICD) and later adapted to external defibrillators. Biphasic truncated exponential wave form and rectilinear biphasic waveform are two types of biphasic waveforms used by different manufacturers. Defibrillators can sense the thoracic impedance and increase or decrease their internal resistance so that the selected level of energy is delivered to the subject.
Biphasic shocks are more effective than monophasic shocks and need lesser energy. Typically when 360 Joules are delivered for defibrillation in a monophasic defibrillator, 200 Joules are given in a biphasic defibrillator. This could theoretically reduce the potential damage to the heart muscle by the high voltage shock.
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