Part 5: Electrical Therapies: Automated External Defibrillators, Defibrillation, Cardioversion, and Pacing

This chapter presents guidelines for defibrillation with automated external defibrillators (AEDs) and manual defibrillators, synchronized cardioversion, and pacing. AEDs may be used by lay rescuers and healthcare providers as part of basic life support. Manual defibrillation, cardioversion, and pacing are advanced life support therapies. Early defibrillation is critical to survival from sudden cardiac arrest (SCA) for several reasons: (1) the most frequent initial rhythm in witnessed SCA is ventricular fibrillation (VF), (2) the treatment for VF is electrical defibrillation, (3) the probability of successful defibrillation diminishes rapidly over time, and (4) VF tends to deteriorate to asystole within a few minutes.1 Several studies have documented the effects of time to defibrillation and the effects of bystander CPR on survival from SCA. For every minute that passes between collapse and defibrillation, survival rates from witnessed VF SCA decrease 7% to 10% if no CPR is provided.1 When bystander CPR is provided, the decrease in survival rates is more gradual and averages 3% to 4% per minute from collapse to defibrillation.1,2 CPR can double1–3 or triple4 survival from witnessed SCA at most intervals to defibrillation. If bystanders provide immediate CPR, many adults in VF can survive with intact neurologic function, especially if defibrillation is performed within about 5 minutes after SCA.5,6 CPR prolongs VF7–9 (ie, the window of time during which defibrillation can occur) and provides a small amount of blood flow that may maintain some oxygen and substrate delivery to the heart and brain.10 Basic CPR alone, however, is unlikely to eliminate VF and restore a perfusing rhythm. ### New Recommendations to Integrate CPR and AED Use To treat VF SCA, rescuers must be able to rapidly integrate CPR with use of the AED. To give the victim the best chance of survival, 3 actions must occur within the first moments of …

[1]  P. H. Miller.  Potential fire hazard in defibrillation. , 1972, JAMA.

[2]  Sinclair-Smith Bc,et al.  Electrical Reversion of Cardiac Arrhythmias , 1972, Southern medical journal.

[3]  G A Ewy,et al.  Myocardial Necrosis from Direct Current Countershock: Effect of Paddle Electrode Size and Time Interval Between Discharges , 1974, Circulation.

[4]  L. Geddes,et al.  Energy dose for ventricular defibrillation of children. , 1976, Pediatrics.

[5]  R. Kerber,et al.  Transthoracic Resistance in Human Defibrillation. Influence of Body Weight, Chest Size, Serial Shocks, Paddle Size and Paddle Contact Pressure , 1981, Circulation.

[6]  M. Copass,et al.  Ventricular defibrillation -- a comparative trial using 175-J and 320-J shocks. , 1982, The New England journal of medicine.

[7]  S. Barold,et al.  Adverse acute and chronic effects of electrical defibrillation and cardioversion on implanted unipolar cardiac pacing systems. , 1983, Journal of the American College of Cardiology.

[8]  W. Dalsey,et al.  Transthoracic pacing in cardiac asystole. , 1984, The American journal of emergency medicine.

[9]  J B Martins,et al.  Self-adhesive preapplied electrode pads for defibrillation and cardioversion. , 1984, Journal of the American College of Cardiology.

[10]  M. Copass,et al.  Improved neurologic recovery and survival after early defibrillation. , 1984, Circulation.

[11]  K Kelly,et al.  Advance prediction of transthoracic impedance in human defibrillation and cardioversion: importance of impedance in determining the success of low-energy shocks. , 1984, Circulation.

[12]  J. Ornato,et al.  Pacemaker insertion for prehospital bradyasystolic cardiac arrest. , 1984, Annals of emergency medicine.

[13]  M. Eisenberg,et al.  SENSITIVITY, ACCURACY, AND SAFETY OF AN AUTOMATIC EXTERNAL DEFIBRILLATOR Report of a Field Evaluation , 1984, The Lancet.

[14]  A. Hallstrom,et al.  Automatic external defibrillation: evaluations of its role in the home and in emergency medical services. , 1984, Annals of emergency medicine.

[15]  R. Kerber,et al.  Automated impedance-based energy adjustment for defibrillation: experimental studies. , 1985, Circulation.

[16]  R. Kerber,et al.  Experimental evaluation and initial clinical application of new self-adhesive defibrillation electrodes. , 1985, International journal of cardiology.

[17]  M. Copass,et al.  Amplitude of ventricular fibrillation waveform and outcome after cardiac arrest. , 1985, Annals of internal medicine.

[18]  R O Cummins,et al.  Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. , 1985, The American journal of emergency medicine.

[19]  J. Hedges,et al.  Emergency department use of transcutaneous pacing for cardiac arrests , 1985, Critical care medicine.

[20]  J. Rosborough,et al.  Endocardial and transcutaneous cardiac pacing, calcium chloride, and epinephrine in postcountershock asystole and bradycardias , 1985, Critical care medicine.

[21]  R. Falk,et al.  External cardiac pacing during in-hospital cardiac arrest. , 1986, The American journal of cardiology.

[22]  J. Hedges,et al.  Prehospital trial of emergency transcutaneous cardiac pacing. , 1987, Circulation.

[23]  R. Kerber,et al.  Defibrillation of high-risk patients during coronary angiography using self-adhesive, preapplied electrode pads. , 1987, The American journal of cardiology.

[24]  R. Kerber,et al.  Self-adhesive monitor/defibrillation pads improve prehospital defibrillation success. , 1987, Annals of emergency medicine.

[25]  D. Nelson,et al.  Prehospital care of the pulseless, nonbreathing pediatric patient. , 1987, The American journal of emergency medicine.

[26]  J B Martins,et al.  Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment. , 1988, Circulation.

[27]  J. Ornato,et al.  Spark-generating properties of electrode gels used during defibrillation. A potential fire hazard. , 1988, JAMA.

[28]  E. Barthell,et al.  Prehospital external cardiac pacing: a prospective, controlled clinical trial. , 1988, Annals of emergency medicine.

[29]  B B Lerman,et al.  Current-based versus energy-based ventricular defibrillation: a prospective study. , 1988, Journal of the American College of Cardiology.

[30]  Deborah S. Smith,et al.  Prehospital countershock treatment of pediatric asystole. , 1989, American Journal of Emergency Medicine.

[31]  A. Adgey,et al.  Electrode pad size, transthoracic impedance and success of external ventricular defibrillation. , 1989, The American journal of cardiology.

[32]  R F Griffith,et al.  Median frequency--a new parameter for predicting defibrillation success rate. , 1991, Annals of emergency medicine.

[33]  R. Kerber,et al.  Ventricular Tachycardia Rate and Morphology Determine Energy and Current Requirements for Transthoracic Cardioversion , 1992, Circulation.

[34]  J. Adgey,et al.  The accuracy of decision-making of a semi-automatic defibrillator during cardiac arrest , 1992, 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[35]  S. Gardner,et al.  Report of nitropatch explosions complicating defibrillation. , 1992, The American journal of emergency medicine.

[36]  M. P. Larsen,et al.  The epidemiology of cardiac arrest in young adults. , 1992, Annals of emergency medicine.

[37]  R. Cummins,et al.  Transcutaneous cardiac pacing in the treatment of out-of-hospital pediatric cardiac arrests. , 1991, Annals of emergency medicine.

[38]  A. Hallstrom,et al.  Predicting survival from out-of-hospital cardiac arrest: a graphic model. , 1993, Annals of emergency medicine.

[39]  P. Pepe,et al.  Initial countershock in the treatment of asystole. , 1993, Resuscitation.

[40]  A. Hallstrom,et al.  Out-of-hospital transcutaneous pacing by emergency medical technicians in patients with asystolic cardiac arrest. , 1993, The New England journal of medicine.

[41]  M. Callaham,et al.  Prehospital cardiac arrest treated by urban first-responders: profile of patient response and prediction of outcome by ventricular fibrillation waveform. , 1993, Annals of emergency medicine.

[42]  Wanchun Tang,et al.  Ventricular fibrillation voltage as a monitor of the effectiveness of cardiopulmonary resuscitation. , 1994, The Journal of laboratory and clinical medicine.

[43]  Fires from defibrillation during oxygen administration. , 1994, Health devices.

[44]  Roger D. White,et al.  Early defibrillation by police: initial experience with measurement of critical time intervals and patient outcome. , 1994, Annals of emergency medicine.

[45]  W. King,et al.  Outcome and cost at a children's hospital following resuscitation for out-of-hospital cardiopulmonary arrest. , 1995, Archives of pediatrics & adolescent medicine.

[46]  J. Ornato,et al.  Public access defibrillation. A statement for healthcare professionals from the American Heart Association Task Force on Automatic External Defibrillation. , 1995, Circulation.

[47]  L. Bossaert,et al.  Semi-automatic external defibrillation and implanted cardiac pacemakers: understanding the interactions during resuscitation. , 1995, Resuscitation.

[48]  J. Ornato,et al.  American Heart Association Report on the Public Access Defibrillation Conference December 8-10, 1994. Automatic External Defibrillation Task Force. , 1995, Circulation.

[49]  R. Swor,et al.  Bystander CPR, Ventricular Fibrillation, and Survival in Witnessed, Unmonitored Out-of-Hospital Cardiac Arrest , 1995 .

[50]  R. Cummins,et al.  CPR and the single rescuer: at what age should you "call first" rather than "call fast"? , 1996, Annals of emergency medicine.

[51]  C. Fahrenbruch,et al.  Out-of-hospital ventricular fibrillation in children and adolescents: causes and outcomes. , 1995, Annals of emergency medicine.

[52]  D. Atkins,et al.  Optimal size of self-adhesive preapplied electrode pads in pediatric defibrillation. , 1995, The American journal of cardiology.

[53]  R. Swor,et al.  Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest. , 1996, Annals of emergency medicine.

[54]  R. Cummins,et al.  CPR and the Single Rescuer: At What Age Should You "Call First" Rather Than "Call Fast?"☆☆☆★ , 1995 .

[55]  W. Kaye,et al.  Organizing and implementing a hospital-wide first-responder automated external defibrillation program: strengthening the in-hospital chain of survival. , 1995, Resuscitation.

[56]  A. Dietrich,et al.  Pediatric patients requiring CPR in the prehospital setting. , 1995, Annals of emergency medicine.

[57]  R. Dzwonczyk,et al.  Signal analysis of the human electrocardiogram during ventricular fibrillation: frequency and amplitude parameters as predictors of successful countershock. , 1996, Annals of emergency medicine.

[58]  J. Ornato,et al.  The mystery of bradyasystole during cardiac arrest. , 1996, Annals of emergency medicine.

[59]  K. Lindner,et al.  Spectral analysis of ventricular fibrillation and closed-chest cardiopulmonary resuscitation. , 1996, Resuscitation.

[60]  S. Sermasi,et al.  Automatic external defibrillators in the hospital as well? , 1996, Resuscitation.

[61]  Roger D. White,et al.  High discharge survival rate after out-of-hospital ventricular fibrillation with rapid defibrillation by police and paramedics. , 1996, Annals of emergency medicine.

[62]  M. E. Ward.  Risk of fires when using defibrillators in an oxygen enriched atmosphere. , 1996, Resuscitation.

[63]  Richard E. Kerber,et al.  Automatic external defibrillators for public access defibrillation , 1997 .

[64]  D J Roe,et al.  Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. , 1997, Circulation.

[65]  H U Strohmenger,et al.  Analysis of the ventricular fibrillation ECG signal amplitude and frequency parameters as predictors of countershock success in humans. , 1997, Chest.

[66]  Richard E. Kerber,et al.  Automatic External Defibrillators for Public Access Defibrillation: Recommendations for Specifying and Reporting Arrhythmia Analysis Algorithm Performance, Incorporating New Waveforms, and Enhancing Safety , 1997, Biomedical instrumentation & technology.

[67]  Carlton B. Morgan,et al.  Low‐Energy Impedance‐Compensating Biphasic Waveforms Terminate Ventricular Fibrillation at High Rates in Victims of Out‐of‐Hospital Cardiac Arrest , 1997, Journal of cardiovascular electrophysiology.

[68]  C. Fahrenbruch,et al.  Public locations of cardiac arrest. Implications for public access defibrillation. , 1998, Circulation.

[69]  Thomas D. Lyster,et al.  Treatment of out-of-hospital cardiac arrest with a low-energy impedance-compensating biphasic waveform automatic external defibrillator. The LIFE Investigators. , 1998, Biomedical instrumentation & technology.

[70]  Roger D. White,et al.  Seven years' experience with early defibrillation by police and paramedics in an emergency medical services system. , 1998, Resuscitation.

[71]  Roger D. White,et al.  External defibrillation: the need for uniformity in analyzing and reporting results. , 1998, Annals of emergency medicine.

[72]  J P Ornato,et al.  Potential cost-effectiveness of public access defibrillation in the United States. , 1998, Circulation.

[73]  V. Mosesso,et al.  Performance of police first responders in utilizing automated external defibrillation on victims of sudden cardiac arrest. , 1998, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[74]  R. White,et al.  Electrocardiographic evaluation of defibrillation shocks delivered to out-of-hospital sudden cardiac arrest patients. , 1999, Resuscitation.

[75]  M. J. Goldman,et al.  A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. , 1999, Annals of emergency medicine.

[76]  H. Calkins,et al.  Comparison of a novel rectilinear biphasic waveform with a damped sine wave monophasic waveform for transthoracic ventricular defibrillation. ZOLL Investigators. , 1999, Journal of the American College of Cardiology.

[77]  M. Weil,et al.  Electrocardiographic prediction of the success of cardiac resuscitation. , 1999, Critical care medicine.

[78]  M. Copass,et al.  Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation , 1999, JAMA.

[79]  D. Atkins,et al.  Successful use of a biphasic waveform automated external defibrillator in a high-risk child. , 2000, The American journal of cardiology.

[80]  D J Roe,et al.  Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. , 2000, The New England journal of medicine.

[81]  J. Herlitz,et al.  Effect of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients in Sweden. , 2000, Resuscitation.

[82]  Richard C. Nova,et al.  A comparison of biphasic and monophasic shocks for external defibrillation. Physio-Control Biphasic Investigators. , 2000, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[83]  James K. Russell,et al.  Multicenter, Randomized, Controlled Trial of 150-J Biphasic Shocks Compared With 200- to 360-J Monophasic Shocks in the Resuscitation of Out-of-Hospital Cardiac Arrest Victims , 2000, Circulation.

[84]  P. Tchou,et al.  Transthoracic cardioversion of atrial fibrillation: comparison of rectilinear biphasic versus damped sine wave monophasic shocks. , 2000, Circulation.

[85]  S. O. Aase,et al.  Predicting Outcome of Defibrillation by Spectral Characterization and Nonparametric Classification of Ventricular Fibrillation in Patients With Out-of-Hospital Cardiac Arrest , 2000, Circulation.

[86]  J. Herlitz,et al.  Incidence, duration and survival of ventricular fibrillation in out-of-hospital cardiac arrest patients in sweden. , 2000, Resuscitation.

[87]  P. Steen,et al.  The Predictive Value of Ventricular Fibrillation Electrocardiogram Signal Frequency and Amplitude Variables in Patients with Out-Of-Hospital Cardiac Arrest , 2001, Anesthesia and analgesia.

[88]  Vincent N. Mosesso,et al.  Scaling Exponent Predicts Defibrillation Success for Out-of-Hospital Ventricular Fibrillation Cardiac Arrest , 2001, Circulation.

[89]  R. Waalewijn,et al.  Bystander initiated actions in out-of-hospital cardiopulmonary resuscitation: results from the Amsterdam Resuscitation Study (ARRESUST). , 2001, Resuscitation.

[90]  岡田 和夫,et al.  話題 「Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care--International Consensus on Science」の日本における普及と取り組み , 2001 .

[91]  Robert A. Berg,et al.  Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest , 2001, Circulation.

[92]  M H Weil,et al.  Optimizing timing of ventricular defibrillation , 2001, Critical care medicine.

[93]  R. Kerber,et al.  Pediatric transthoracic defibrillation: biphasic versus monophasic waveforms in an experimental model. , 2001, Resuscitation.

[94]  H U Strohmenger,et al.  Analysing ventricular fibrillation ECG-signals and predicting defibrillation success during cardiopulmonary resuscitation employing N(alpha)-histograms. , 2001, Resuscitation.

[95]  P. Tchou,et al.  Multicenter study of principles-based waveforms for external defibrillation. , 2001, Annals of emergency medicine.

[96]  Thomas D. Lyster,et al.  Is Arrhythmia Detection by Automatic External Defibrillator Accurate for Children?: Sensitivity and Specificity of an Automatic External Defibrillator Algorithm in 696 Pediatric Arrhythmias , 2001, Circulation.

[97]  N. Fineberg,et al.  Limited response to cardiac arrest by police equipped with automated external defibrillators: lack of survival benefit in suburban and rural Indiana--the police as responder automated defibrillation evaluation (PARADE). , 2001, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[98]  L. Bossaert,et al.  Optimal Response to Cardiac Arrest study: defibrillation waveform effects. , 2001, Resuscitation.

[99]  W F van Gunsteren,et al.  Fibrillation power, an alternative method of ECG spectral analysis for prediction of countershock success in a porcine model of ventricular fibrillation. , 2001, Resuscitation.

[100]  Wanchun Tang,et al.  Predicting the success of defibrillation by electrocardiographic analysis. , 2002, Resuscitation.

[101]  Robert A. Berg,et al.  Importance of Continuous Chest Compressions During Cardiopulmonary Resuscitation: Improved Outcome During a Simulated Single Lay-Rescuer Scenario , 2002, Circulation.

[102]  Wanchun Tang,et al.  Adverse Outcomes of Interrupted Precordial Compression During Automated Defibrillation , 2002, Circulation.

[103]  P. Steen,et al.  Effects of Interrupting Precordial Compressions on the Calculated Probability of Defibrillation Success During Out-of-Hospital Cardiac Arrest , 2002 .

[104]  David E. Snyder,et al.  Energy attenuator for pediatric application of an automated external defibrillator , 2002, Critical care medicine.

[105]  Delays in defibrillation: influence of different monitoring techniques. , 2002, British journal of anaesthesia.

[106]  P. Steen,et al.  Effects of Interrupting Precordial Compressions on the Calculated Probability of Defibrillation Success During Out-of-Hospital Cardiac Arrest , 2002, Circulation.

[107]  Roger D. White,et al.  Refibrillation, resuscitation and survival in out-of-hospital sudden cardiac arrest victims treated with biphasic automated external defibrillators. , 2002, Resuscitation.

[108]  A. Amann,et al.  The Prediction of Defibrillation Outcome Using a New Combination of Mean Frequency and Amplitude in Porcine Models of Cardiac Arrest , 2002, Anesthesia and analgesia.

[109]  David E. Snyder,et al.  Fixed-energy biphasic waveform defibrillation in a pediatric model of cardiac arrest and resuscitation , 2002, Critical care medicine.

[110]  R. Kerber,et al.  Biphasic versus monophasic shock waveform for conversion of atrial fibrillation: the results of an international randomized, double-blind multicenter trial. , 2002, Journal of the American College of Cardiology.

[111]  T. Ngarmukos,et al.  Comparison of the efficacy and safety of two biphasic defibrillator waveforms for the conversion of atrial fibrillation to sinus rhythm. , 2003, The American journal of cardiology.

[112]  Thomas D Rea,et al.  Defibrillation waveform and post-shock rhythm in out-of-hospital ventricular fibrillation cardiac arrest. , 2003, Resuscitation.

[113]  Jonathan C Craig,et al.  Biphasic and monophasic shocks for transthoracic defibrillation: a meta analysis of randomised controlled trials. , 2003, Resuscitation.

[114]  Sandeep Vijan,et al.  Public use of automated external defibrillators. , 2003, The New England journal of medicine.

[115]  D. R. Hampton,et al.  Specificity and sensitivity of automated external defibrillator rhythm analysis in infants and children. , 2003, Annals of emergency medicine.

[116]  J. Ornato,et al.  Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. , 2003, Resuscitation.

[117]  P. Steen,et al.  Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. , 2003, JAMA.

[118]  R. Berg,et al.  Fire attributable to a defibrillation attempt in a neonate. , 2003, Pediatrics.

[119]  M. Hazinski,et al.  Use of Automated External Defibrillators for Children: an Update an Advisory Statement from the Pediatric Advanced Life Support Task Force, International Liaison Committee on Resuscitation Writing Group Members of the Pals Task Force , 2022 .

[120]  M. Brezocnik,et al.  Predicting defibrillation success by 'genetic' programming in patients with out-of-hospital cardiac arrest. , 2003, Resuscitation.

[121]  Tim P. DeMonte,et al.  Measurement of thoracic current flow in pigs for the study of defibrillation and cardioversion , 2003, IEEE Transactions on Biomedical Engineering.

[122]  A. Hart,et al.  A prospective, randomised and blinded comparison of first shock success of monophasic and biphasic waveforms in out-of-hospital cardiac arrest. , 2003, Resuscitation.

[123]  Nremt-P,et al.  Dynamic nature of electrocardiographic waveform predicts rescue shock outcome in porcine ventricular fibrillation. , 2003, Annals of emergency medicine.

[124]  R. Walker,et al.  Biphasic Shocks Compared with Monophasic Damped Sine Wave Shocks for Direct Ventricular Defibrillation during Open Heart Surgery , 2003, Anesthesiology.

[125]  Paul Dorian,et al.  A randomized trial comparing monophasic and biphasic waveform shocks for external cardioversion of atrial fibrillation. , 2004, American heart journal.

[126]  J P Ornato,et al.  Public-access Defibrillation and Survival after Out-of-hospital Cardiac Arrest Recommended Citation Public-access Defibrillation and Survival after Out-of-hospital Cardiac Arrest , 2022 .

[127]  Richard C. Nova,et al.  Attenuated adult biphasic shocks compared with weight-based monophasic shocks in a swine model of prolonged pediatric ventricular fibrillation. , 2004, Resuscitation.

[128]  S. Walsh,et al.  Efficacy of distinct energy delivery protocols comparing two biphasic defibrillators for cardiac arrest. , 2004, The American journal of cardiology.

[129]  Roger D. White,et al.  Early Out-of-Hospital Experience with an Impedance-Compensating Low-Energy Biphasic Waveform Automatic External Defibrillator , 1997, Journal of Interventional Cardiac Electrophysiology.

[130]  Henry E. Wang,et al.  Ventricular Fibrillation Scaling Exponent Can Guide Timing of Defibrillation and Other Therapies , 2004, Circulation.

[131]  J. Fisher,et al.  Comparison of rectilinear biphasic waveform energy versus truncated exponential biphasic waveform energy for transthoracic cardioversion of atrial fibrillation. , 2004, The American journal of cardiology.

[132]  P. Steen,et al.  Effects of Cardiopulmonary Resuscitation on Predictors of Ventricular Fibrillation Defibrillation Success During Out-of-Hospital Cardiac Arrest , 2004, Circulation.

[133]  J. Brewer,et al.  RECTILINEAR BIPHASIC WAVEFORM DEFIBRILLATION OF OUT-OF-HOSPITAL CARDIAC ARREST , 2004, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[134]  S. Walsh,et al.  Theory and practice of defibrillation: (1) Atrial fibrillation and DC conversion , 2004, Heart.

[135]  Andrea G. Backscheider,et al.  A program encouraging early defibrillation results in improved in-hospital resuscitation efficacy. , 2004, Journal of the American College of Cardiology.

[136]  David E. Snyder,et al.  Transthoracic impedance does not affect defibrillation, resuscitation or survival in patients with out-of-hospital cardiac arrest treated with a non-escalating biphasic waveform defibrillator. , 2005, Resuscitation.

[137]  B. Abella,et al.  Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. , 2005, JAMA.

[138]  J. Finn,et al.  CPR before defibrillation in out‐of‐hospital cardiac arrest: A randomized trial , 2005, Emergency medicine Australasia : EMA.

[139]  D. Atkins,et al.  Attenuated pediatric electrode pads for automated external defibrillator use in children. , 2005, Resuscitation.

[140]  Roger D. White,et al.  Ventricular fibrillation is not provoked by chest compression during post-shock organized rhythms in out-of-hospital cardiac arrest. , 2005, Resuscitation.

[141]  Wanchun Tang,et al.  Lay Rescuer Automated External Defibrillator (“Public Access Defibrillation”) Programs: Lessons Learned From an International Multicenter Trial Advisory Statement From the American Heart Association Emergency Cardiovascular Committee; the Council on Cardiopulmonary, Perioperative, and Critical Care; , 2005, Circulation.

[142]  P. Steen,et al.  Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. , 2005, JAMA.

[143]  M. Sayre,et al.  Providing automated external defibrillators to urban police officers in addition to a fire department rapid defibrillation program is not effective. , 2005, Resuscitation.

[144]  Roger D. White,et al.  Prospective, randomized comparison of two biphasic waveforms for the efficacy and safety of transthoracic biphasic cardioversion of atrial fibrillation. , 2005, Heart rhythm.

[145]  L. Morrison,et al.  Out-of-hospital cardiac arrest rectilinear biphasic to monophasic damped sine defibrillation waveforms with advanced life support intervention trial (ORBIT). , 2005, Resuscitation.

[146]  Roger D. White,et al.  Evolution of a community-wide early defibrillation programme experience over 13 years using police/fire personnel and paramedics as responders. , 2005, Resuscitation.

[147]  L. P. Tham,et al.  Paediatric out-of-hospital cardiac arrests: epidemiology and outcome. , 2005, Singapore medical journal.

[148]  Wiebe H K de Vries,et al.  Trained first-responders with an automated external defibrillator: how do they perform in real resuscitation attempts? , 2005, Resuscitation.