What is the principal mechanism of biphasic defibrillation?

Biphasic defibrillation operates based on the principle of delivering a shock that travels in two distinct directions. This approach involves discharging half of the energy in one direction and then reversing polarity to discharge the remaining energy in the opposite direction. This method is advantageous because it has been shown to be more effective at restoring normal heart rhythms compared to monophasic defibrillation, which only delivers a single-direction shock.

The dual-phase approach allows for better heart depolarization and increases the likelihood of successful defibrillation. By reversing the flow of electricity, biphasic defibrillation can reduce the threshold energy required to achieve defibrillation, thereby minimizing potential damage to the heart muscle.

A different approach, such as delivering a charge in one direction only, does not utilize the advantages offered by the biphasic method, making it less effective. Also, delivering a constant level of charge throughout does not allow for the dynamic adjustment that biphasic defibrillation provides, leading to less optimal outcomes. Finally, while biphasic defibrillation does allow for some energy efficiencies, the assertion of delivering higher energy than monophasic defibrillation isn't the principal mechanism; instead, it's more about the effectiveness of the waveform and energy delivery pattern