What is the key difference in energy requirement between monophasic and biphasic shock for cardioversion?

Biphasic shock is designed to require less energy than monophasic shock for effective cardioversion. This increased efficiency is due to the way biphasic shocks are delivered: the energy is delivered in two phases, moving in opposite directions through the heart. This can result in more effective depolarization of the myocardium with lower total energy output.

Research and clinical practice have shown that using lower energy levels in biphasic shocks leads to similar or improved outcomes in converting arrhythmias compared to the higher energy levels typically used with monophasic shocks. Therefore, when considering defibrillation or cardioversion protocols, this more effective energy requirement translates to a reduced risk of damage to the myocardium as well.

Thus, the key distinction is that biphasic energy delivery can achieve successful cardioversion with less total energy compared to monophasic delivery, highlighting its advantages in clinical settings.