Document Detail


Clinical efficacy of a wearable defibrillator in acutely terminating episodes of ventricular fibrillation using biphasic shocks.
MedLine Citation:
PMID:  14516344     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Wearable Cardioverter Defibrillator (WCD) automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander, while at the same time allowing the patient to ambulate freely. It represents an alternative to emergency medical services for outpatient populations with a temporary risk of sudden cardiac death. While the original devices used a monophasic truncated exponential waveform for cardioversion/defibrillation shocks, a new, biphasic shock was developed for the next device generation. In 12 patients undergoing electrophysiological testing for ventricular tachyarrhythmias, termination of electrically induced ventricular fibrillation (VF) was attempted via the WCD. In 22 episodes, induced VF was promptly terminated by the first 70 J (n=12) or 100 J (n=10) biphasic shocks. Time between arrhythmia initiation and shock delivery was 22 +/- 6 seconds (70 J) and 21 +/- 6 seconds (100 J) (P=NS). The measured transthoracic impedance was 71 +/- 5 Ohms (64-79 Ohms) for the 70 J shock and 64 +/- 8 Ohms (47-72 Ohms) for the 100 J shock. The present study demonstrates that a single low energy biphasic shock delivered by the WCD, reliably terminates electrically induced VF (100% of episodes). The results of this study suggest that there is an acceptable safety margin to the maximum output of the device (150 J). Despite our promising data, we recommend that programming all shocks for maximum energy output should be done when using the WCD in ambulatory patients.
Authors:
Sven Reek; J Christoph Geller; Ulf Meltendorf; Anke Wollbrueck; Steven J Szymkiewicz; Helmut U Klein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-30     Completed Date:  2004-02-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2016-22     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University Hospital Magdeburg, Germany. sven.reek@medizin.uni-magdeburg.de
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care / methods*
Death, Sudden, Cardiac / prevention & control
Electric Countershock / instrumentation*
Female
High-Energy Shock Waves
Humans
Male
Middle Aged
Treatment Outcome
Ventricular Fibrillation / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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