Proposal for a Methodology and a Controlled Charging Source for Waveform Optimization in Transthoracic Defibrillation
摘要
Electrical defibrillation is a key procedure in emergency medical care, though its application involves risks related to tissue damage caused by the electric shock. The main objective of this work is to propose an innovative methodology for the development of an optimal waveform for transthoracic defibrillation, aiming to minimize the applied energy without compromising effectiveness. To this end, a critical analysis of the current state of the art in defibrillator waveforms was conducted, along with an in-depth study of the bioelectrical properties of the cardiac cell membrane. Due to the complexity of modeling myocardial electrical response from scratch, previously validated models were used and selected based on their relevance. Based on these models, a controlled-charging source was designed, capable of precisely adjusting charge delivery during defibrillation. The validation of this proposal follows a stepwise methodology that includes ex vivo experimentation on isolated hearts, extrapolation to a human thoracic model, and eventually, clinical trials. This approach is expected to significantly reduce the energy required to achieve effective defibrillation, thereby minimizing collateral damage. The main limitations identified relate to the complexity of physiological simulation, the extrapolation of ex vivo results to humans, and the clinical feasibility of the proposed design. Despite these challenges, preliminary results suggest a significant advancement toward safer and more personalized defibrillation.