{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T06:47:59Z","timestamp":1774680479837,"version":"3.50.1"},"reference-count":73,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>For cardiac defibrillator testing and design purposes, the range and limits of the human TTI is of high interest. Potential influencing factors regarding the electronic configurations, the electrode\/tissue interface and patient characteristics were identified and analyzed. A literature survey based on 71 selected articles was used to review and assess human TTI and the influencing factors found. The human TTI extended from 12 to 212 \u03a9 in the literature selected. Excluding outliers and pediatric measurements, the mean TTI recordings ranged from 51 to 112 \u03a9 with an average TTI of 76.7 \u03a9 under normal distribution. The wide range of human impedance can be attributed to 12 different influencing factors, including shock waveforms and protocols, coupling devices, electrode size and pressure, electrode position, patient age, gender, body dimensions, respiration and lung volume, blood hemoglobin saturation and different pathologies. The coupling device, electrode size and electrode pressure have the greatest influence on TTI.<\/jats:p>","DOI":"10.3390\/s22072808","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T21:08:22Z","timestamp":1649365702000},"page":"2808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["A Systematic Review of the Transthoracic Impedance during Cardiac Defibrillation"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-9557","authenticated-orcid":false,"given":"Yasmine","family":"Heyer","sequence":"first","affiliation":[{"name":"Institute of Health Care Engineering with European Testing Center of Medical Devices, Graz University of Technology, A-8010 Graz, Austria"}]},{"given":"Daniela","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Clinical Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, A-8036 Graz, Austria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3763-5195","authenticated-orcid":false,"given":"Christian","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Institute of Health Care Engineering with European Testing Center of Medical Devices, Graz University of Technology, A-8010 Graz, Austria"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1111\/j.1540-8159.1995.tb03869.x","article-title":"Impedance to defibrillation countershock: Does an optimal impedance exist?","volume":"18","author":"KenKnight","year":"1995","journal-title":"PACE-Pacing Clin. Electrophysiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.amjcard.2006.01.065","article-title":"Determinants of Thoracic Electrical Impedance in External Electrical Cardioversion of Atrial Fibrillation","volume":"98","author":"Fumagalli","year":"2006","journal-title":"Am. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/014107680509800102","article-title":"How good is your defibrillation technique?","volume":"98","author":"Sado","year":"2005","journal-title":"J. R. Soc. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1161\/01.RES.67.6.1420","article-title":"Relation Between Transcardiac and Transthoracic Current During Defibrillation in Humans","volume":"67","author":"Lerman","year":"1990","journal-title":"Circ. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0300-9572(03)00173-4","article-title":"What is the optimal paddle force during paediatric external defibrillation?","volume":"59","author":"Deakin","year":"2003","journal-title":"Resuscitation"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., and Brennan, S.E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372.","DOI":"10.1136\/bmj.n71"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1088\/0967-3334\/21\/1\/318","article-title":"Transthoracic electrical impedance during external defibrillation: Comparison of measured and modelled waveforms","volume":"21","author":"Hatib","year":"2000","journal-title":"Physiol. Meas."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/03091900110074654","article-title":"Possibilities for predictive measurement of the transthoracic impedance in defibrillation","volume":"25","author":"Krasteva","year":"2001","journal-title":"J. Med. Eng. Technol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0002-9149(00)01026-2","article-title":"Effect of shaving the chest of hirsute subjects on transthoracic impedance to self-adhesive defibrillation electrode pads","volume":"86","author":"Bissing","year":"2000","journal-title":"Am. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1136\/hrt.61.6.502","article-title":"Initial experience with a microprocessor controlled current based defibrillator","volume":"61","author":"Dalzell","year":"1989","journal-title":"Heart"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.resuscitation.2009.04.002","article-title":"Defibrillation probability and impedance change between shocks during resuscitation from out-of-hospital cardiac arrest","volume":"80","author":"Walker","year":"2009","journal-title":"Resuscitation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/S0002-9149(99)80606-7","article-title":"Optimal size of self-adhesive preapplied electrode pads in pediatric defibrillation","volume":"75","author":"Samson","year":"1995","journal-title":"Am. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S706","DOI":"10.1161\/CIRCULATIONAHA.110.970954","article-title":"Part 6: Electrical therapies: Automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"122","author":"Link","year":"2010","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/S0196-0644(97)70245-2","article-title":"Effect of Electrode Position and Gel-Application Technique on Predicted Transcardiac Current During Transthoracic Defibrillation","volume":"29","author":"Caterine","year":"1997","journal-title":"Ann. Emerg. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1161\/01.CIR.63.3.676","article-title":"Transthoracic resistance in human defibrillation. Influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure","volume":"63","author":"Kerber","year":"1981","journal-title":"Circulation"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/0883-9441(89)90071-3","article-title":"Pediatric defibrillation: Importance of paddle size in determining transthoracic impedance","volume":"4","author":"Atkins","year":"1989","journal-title":"J. Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1161\/01.CIR.101.11.1282","article-title":"Transthoracic cardioversion of atrial fibrillation: Comparison of rectilinear biphasic versus damped sine wave monophasic shocks","volume":"101","author":"Mittal","year":"2000","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1016\/S0735-1097(02)01898-3","article-title":"Biphasic versus monophasic shock waveform for conversion of atrial fibrillation: The results of an international randomized, double-blind multicenter trial","volume":"39","author":"Page","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0300-9572(00)00197-0","article-title":"Transthoracic monophasic and biphasic defibrillation in a swine model: A comparison of efficacy, ST segment changes, and postshock hemodynamics","volume":"47","author":"Niemann","year":"2000","journal-title":"Resuscitation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1136\/bmj.2.5966.313","article-title":"Electrical Requirements For Ventricular Defibrillation","volume":"2","author":"Pantridge","year":"1975","journal-title":"Br. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1093\/eurheartj\/ehi196","article-title":"Impedance compensated biphasic waveforms for transthoracic cardioversion of atrial fibrillation: A multi-centre comparison of antero-apical and antero-posterior pad positions","volume":"26","author":"Walsh","year":"2005","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.resuscitation.2008.02.024","article-title":"Changes in transthoracic impedance during sequential biphasic defibrillation","volume":"78","author":"Deakin","year":"2008","journal-title":"Resuscitation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/0002-9149(88)90546-2","article-title":"Factors affecting transthoracic impedance during electrical cardioversion","volume":"62","author":"Sirna","year":"1988","journal-title":"Am. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/j.1540-8159.2008.02246.x","article-title":"Multiple shocks affect thoracic electrical impedance during external cardioversion of atrial fibrillation","volume":"32","author":"Fumagalli","year":"2009","journal-title":"PACE-Pacing Clin. Electrophysiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0300-9572(02)00292-7","article-title":"Transthoracic impedance does not decrease with rapidly repeated countershocks in a swine cardiac arrest model","volume":"56","author":"Niemann","year":"2003","journal-title":"Resuscitation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.resuscitation.2008.03.231","article-title":"Recurrent ventricular fibrillation during advanced life support care of patients with prehospital cardiac arrest","volume":"78","author":"Koster","year":"2008","journal-title":"Resuscitation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S465","DOI":"10.1161\/CIR.0000000000000262","article-title":"Part 8: Post\u2013Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"132","author":"Callaway","year":"2015","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/S0735-1097(84)80258-2","article-title":"Self-adhesive preapplied electrode pads for defibrillation and cardioversion","volume":"3","author":"Kerber","year":"1984","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0300-9572(98)00117-8","article-title":"A comparison of transthoracic impedance using standard defibrillation paddles and self-adhesive defibrillation pads","volume":"39","author":"Deakin","year":"1998","journal-title":"Resuscitation"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.resuscitation.2004.06.002","article-title":"External defibrillation in the left lateral position\u2014A comparison of manual paddles with self-adhesive pads","volume":"63","author":"Dodd","year":"2004","journal-title":"Resuscitation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/S0735-1097(85)80131-5","article-title":"Defibrillator electrode-chest wall coupling agents: Influence on transthoracic impedance and shock success","volume":"6","author":"Aylward","year":"1985","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1172\/JCI107552","article-title":"Electrical dose for ventricular defibrillation of large and small animals using precordial electrodes","volume":"53","author":"Geddes","year":"1974","journal-title":"J. Clin. Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/0002-9149(89)90757-1","article-title":"Electrode pad size, transthoracic impedance and success of external ventricular defibrillation","volume":"64","author":"Dalzell","year":"1989","journal-title":"Am. J. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1161\/01.CIR.64.4.818","article-title":"Determinants of intracardiac current in defibrillation. Experimental studies in dogs","volume":"64","author":"Hoyt","year":"1981","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S0002-9149(02)02623-1","article-title":"Determining the optimal paddle force for external defibrillation","volume":"90","author":"Deakin","year":"2002","journal-title":"Am. J. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/pace.12937","article-title":"Effect of Applying Force to Self-Adhesive Electrodes on Transthoracic Impedance: Implications for Electrical Cardioversion","volume":"39","author":"Ramirez","year":"2016","journal-title":"PACE-Pacing Clin. Electrophysiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.resuscitation.2003.10.001","article-title":"Differential contribution of skin impedance and thoracic volume to transthoracic impedance during external defibrillation","volume":"60","author":"Deakin","year":"2004","journal-title":"Resuscitation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0196-0644(99)70220-9","article-title":"Effect of Application of Force to Self-Adhesive Defibrillator Pads on Transthoracic Electrical Impedance and Countershock Success","volume":"34","author":"Persse","year":"1999","journal-title":"Ann. Emerg. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/S0002-9149(97)00364-0","article-title":"Active compression cardioversion for refractory atrial fibrillation","volume":"80","author":"Cohen","year":"1997","journal-title":"Am. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.amjcard.2003.09.020","article-title":"Comparison of the effects of removal of chest hair with not doing so before external defibrillation on transthoracic impedance","volume":"93","author":"Sado","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0300-9572(02)00290-3","article-title":"Is the orientation of the apical defibrillation paddle of importance during manual external defibrillation?","volume":"56","author":"Deakin","year":"2003","journal-title":"Resuscitation"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0300-9572(98)00050-1","article-title":"Transthoracic defibrillation: Does electrode adhesive pad position alter transthoracic impedance?","volume":"37","author":"Garcia","year":"1998","journal-title":"Resuscitation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.acvd.2014.04.002","article-title":"Anterior-posterior versus anterior-lateral electrode position for external electrical cardioversion of atrial fibrillation: A meta-analysis of randomized controlled trials","volume":"107","author":"Zhang","year":"2014","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1536\/jhj.44.921","article-title":"External Cardioversion in Patients With Persistent Atrial Fibrillation A Reappraisal of the Effects of Electrode Pad Position and Transthoracic Impedance on Cardioversion Success","volume":"44","author":"Chen","year":"2003","journal-title":"Jpn. Heart J."},{"key":"ref_45","first-page":"85","article-title":"Factors Determining Success and Energy Requirements for Cardioversion of Atrial Fibrillation: Revised Version","volume":"78","author":"Dalzell","year":"1991","journal-title":"QJM Int. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/0735-1097(92)90143-B","article-title":"Transthoracic defibrillation: Effect of sternotomy on chest impedance","volume":"20","author":"Kerber","year":"1992","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1136\/hrt.81.6.576","article-title":"Randomised comparison of electrode positions for cardioversion of atrial fibrillation","volume":"81","author":"Mathew","year":"1999","journal-title":"Heart"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1088\/0967-3334\/27\/10\/007","article-title":"Transthoracic impedance study with large self-adhesive electrodes in two conventional positions for defibrillation","volume":"27","author":"Krasteva","year":"2006","journal-title":"Physiol. Meas."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1542\/peds.94.1.90","article-title":"Pediatric defibrillation: Current flow is improved by using \u2019adult\u2019 electrode paddles","volume":"94","author":"Atkins","year":"1994","journal-title":"Pediatrics"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3250","DOI":"10.1161\/01.CIR.0000074201.73984.FD","article-title":"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","volume":"107","author":"Samson","year":"2003","journal-title":"Circulation"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Roh, S.Y., Ahn, J., Lee, K.N., Baek, Y.S., Kim, D.H., Lee, D.I., Shim, J., Choi, J.I., and Kim, Y.H. (2021). The impact of personal thoracic impedance on electrical cardioversion in patients with atrial arrhythmias. Medicina, 57.","DOI":"10.3390\/medicina57060618"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1136\/hrt.65.6.311","article-title":"Determinants of successful transthoracic defibrillation and outcome in ventricular fibrillation","volume":"65","author":"Dalzell","year":"1991","journal-title":"Heart"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/bja\/87.2.237","article-title":"Do physiological changes in pregnancy change defibrillation energy requirements?","volume":"87","author":"Nanson","year":"2001","journal-title":"Br. J. Anaesth."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/0735-1097(95)00487-4","article-title":"Transthoracic defibrillation: Importance of avoiding electrode placement directly on the female breast","volume":"27","author":"Spencer","year":"1996","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Wan, C., Szymkiewicz, S.J., and Klein, H.U. (2017). The impact of body mass index on the wearable cardioverter defibrillator shock efficacy and patient wear time. Am. Heart J., 186.","DOI":"10.1016\/j.ahj.2017.01.007"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S0300-9572(98)00049-5","article-title":"Effects of positive end-expiratory pressure on transthoracic impedance\u2014Implications for defibrillation","volume":"37","author":"Deakin","year":"1998","journal-title":"Resuscitation"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.resp.2014.08.001","article-title":"Influence of lung volume, fluid and capillary recruitment during positional changes and exercise on thoracic impedance in heart failure","volume":"202","author":"Kim","year":"2014","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S0300-9572(98)00099-9","article-title":"Effects of respiratory gas composition on transthoracic impedance","volume":"38","author":"Deakin","year":"1998","journal-title":"Resuscitation"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Berve, P.O., Irusta, U., Kramer-Johansen, J., Sk\u00e5lhegg, T., Kongsg\u00e5rd, H.W., Brunborg, C., Aramendi, E., and Wik, L. (2019). Transthoracic impedance measured with defibrillator pads\u2014New interpretations of signal change induced by ventilations. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050724"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1161\/01.RES.44.1.88","article-title":"Contractures and Increase in Internal Longitudinal Resistance of Cow Ventricular Muscle Induced by Hypoxia","volume":"44","author":"Wojtczak","year":"1979","journal-title":"Circ. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1161\/01.CIR.60.5.1156","article-title":"Evaluation of transthoracic electrical impedance in the diagnosis of pulmonary edema","volume":"60","author":"Fein","year":"1979","journal-title":"Circulation"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/j.1527-5299.2000.80141.x","article-title":"Bioimpedance Monitoring: Better Than Chest X-Ray for Predicting Abnormal Pulmonary Fluid?","volume":"6","author":"Peacock","year":"2000","journal-title":"Congest. Heart Fail."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.resuscitation.2004.10.013","article-title":"Effect of hypothermia on transthoracic defibrillation in a swine model","volume":"65","author":"Rhee","year":"2005","journal-title":"Resuscitation"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1109\/TBME.1983.325140","article-title":"Transventricular Impedance during Fibrillation","volume":"BME-30","author":"Savino","year":"1983","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.resuscitation.2004.06.021","article-title":"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","volume":"64","author":"White","year":"2005","journal-title":"Resuscitation"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1161\/01.CIR.77.5.1038","article-title":"Energy, current, and success in defibrillation and cardioversion: Clinical studies using an automated impedance-based method of energy adjustment","volume":"77","author":"Kerber","year":"1988","journal-title":"Circulation"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1161\/01.CIR.70.2.303","article-title":"Advance prediction of transthoracic impedance in human defibrillation and cardioversion: Importance of impedance in determining the success of low-energy shocks","volume":"70","author":"Kerber","year":"1984","journal-title":"Circulation"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/S0002-9149(96)00574-7","article-title":"Current-based transthoracic defibrillation","volume":"78","author":"Kerber","year":"1996","journal-title":"Am. J. Cardiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.resuscitation.2010.07.011","article-title":"Analysis of transthoracic impedance during real cardiac arrest defibrillation attempts in older children and adolescents: Are stacked-shocks appropriate?","volume":"81","author":"Niles","year":"2010","journal-title":"Resuscitation"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1002\/clc.22947","article-title":"Association between transthoracic impedance and electrical cardioversion success with biphasic defibrillators: An analysis of 1055 shocks for atrial fibrillation and flutter","volume":"41","author":"Sadek","year":"2018","journal-title":"Clin. Cardiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1093\/europace\/euy285","article-title":"Evaluation of a novel cardioversion intervention for atrial fibrillation: The Ottawa AF cardioversion protocol","volume":"21","author":"Ramirez","year":"2019","journal-title":"Europace"},{"key":"ref_72","first-page":"1","article-title":"Orthogonal electrical cardioversion in atrial fibrillation refractory to biphasic shocks: A case series","volume":"4","year":"2020","journal-title":"Eur. Heart J.-Case Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"432","DOI":"10.11622\/smedj.2017070","article-title":"Role of peak current in conversion of patients with ventricular fibrillation","volume":"58","author":"Anantharaman","year":"2017","journal-title":"Singap. Med. J."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/7\/2808\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:49:08Z","timestamp":1760136548000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/7\/2808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,6]]},"references-count":73,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["s22072808"],"URL":"https:\/\/doi.org\/10.3390\/s22072808","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,6]]}}}