A study of energy requirements for defibrillation using various shocking sequences

Recent work suggests that two sequential shocks given with two separate lead configurations, and the second pair of electrodes located in areas to enhance the potential gradient field where the first pair of electrodes is weak, can improve defibrillation efficacy compared to a single shock given to either of the pairs of electrodes alone. A simple model that permits rapid identification of weak field regions and the evaluation of the energy required for particular sequence configurations is examined. The results strongly suggest that three sequential shocks require considerably less energy than two sequential shocks.