Evaluation of the Influence of the Rise and Fall Times of a Monophasic Trapezoidal Defibrillation Pulse on Its Energy Efficiency Using the ten Tusscher–Panfilov Cardiomyocyte Model

Abstract

The ten Tusscher–Panfilov 2006 cardiomyocyte model was subjected to simulated fibrillation to determine the dependence of the threshold energy of guaranteed defibrillation on the duration of the trapezoidal defibrillation pulse with sloping rise and fall for different rise and fall times. According to the guaranteed defibrillation hypothesis, the duration of the current refractory period of all myocardial myocytes after exposure to a defibrillation pulse should be no less than the duration of the period of the fibrillation waves. This can lead to the cessation of the propagation of fibrillation waves through the myocardium. Computer simulation showed that the threshold energy of guaranteed defibrillation decreases only with an increase in the pulse rise time until the threshold energy of the energy-optimal half-sine pulse is reached. An increase in the pulse fall time reduces the threshold defibrillation energy spread in the range of energy-efficient pulse durations. In this case, the range of energy-efficient pulse durations shifts toward greater values.