Document Detail

Changes in pacing threshold and R wave amplitude after transvenous catheter countershock.
MedLine Citation:
PMID:  6470334     Owner:  NLM     Status:  MEDLINE    
Transvenous electrode catheter countershock in patients with recurrent ventricular tachyarrhythmias may be followed by transient bradycardia and require temporary pacing with a catheter. The serial changes in R wave amplitude and stimulation threshold after catheter countershock in 11 halothane-anesthetized open chest dogs ranging in weight from 11.8 to 24 kg were studied. Ventricular fibrillation was electrically induced and followed by catheter defibrillation using nonsynchronized trapezoidal waveform (65% tilt) current discharge in incremental doses (5 to 50 J). Significant decreases in bipolar R wave amplitude (8.3 +/- 1 versus 2 +/- 0.2 mV, p less than 0.001) and increases in stimulation threshold (1 +/- 0.1 versus 2.3 +/- 0.4 V, p less than 0.001) were observed using the countershock catheter 15 seconds after countershock; these changes persisted for up to 10 minutes. To determine whether these changes were localized to the defibrillating catheter and whether they were species-specific, a second electrode catheter was positioned in the right ventricle distant from the countershock catheter in five pigs. Increases in stimulation threshold were observed only at the countershock catheter, suggesting that changes were secondary to local changes at the catheter-myocardium interface. No significant change in R wave amplitude or stimulation threshold was observed at the countershock catheter in three pigs given transthoracic shocks (60 to 250 J). It is concluded that current discharge through the countershock catheter results in a significant temporary reduction in R wave amplitude and an increase in pacing threshold. This may make pacing through the countershock catheter unreliable after shock delivery.
R Yee; D L Jones; E Jarvis; A P Donner; G J Klein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  4     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1984 Sep 
Date Detail:
Created Date:  1984-09-26     Completed Date:  1984-09-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  543-9     Citation Subset:  IM    
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MeSH Terms
Electric Countershock* / adverse effects
Heart Catheterization / instrumentation,  methods*

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