Document Detail


Clinical transvenous cardioversion of recurrent life-threatening ventricular tachyarrhythmias: low energy synchronized cardioversion of ventricular tachycardia and termination of ventricular fibrillation in patients using a catheter electrode.
MedLine Citation:
PMID:  7072583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to test the efficacy, safety, and patient tolerance of transvenous cardioversion and defibrillation in patients who had recurrent ventricular tachyarrhythmias. In five of seven patients, a truncated exponential shock of 0.025 to 2.0 joules synchronized to the QRS complex terminated 47 episodes of recurrent sustained ventricular tachycardia (VT). Cardioversion threshold was less than or equal to 0.25 joule in three patients and 0.75 to 2.0 joules in two patients. Shocks of 0.75 joule and 2.0 joule failed to terminate VT in one patient each; higher energies were not tried because of hemodynamic decompensation. In one patient, a shock of 25 joules terminated ventricular fibrillation (VF) on three occasions, and in another patient a shock of 1.0 joule terminated atrial fibrillation on one occasion. Shocks less than or equal to 0.5 joule were well tolerated by the awake unsedated patient. One hundred forty of 141 synchronized shocks (including subthreshold shocks) produced no repetitive ventricular activity. In one seriously ill patient who had received multiple antiarrhythmic drugs and required balloon counterpulsation for hemodynamic support, on a single occasion each a synchronized transvenous shock and a synchronized conventional transthoracic shock produced ventricular flutter and ventricular fibrillation (VF), respectively. We conclude that synchronized transvenous cardioversion by a catheter electrode offers promise as a new therapeutic approach.
Authors:
D P Zipes; W M Jackman; J J Heger; D A Chilson; K F Browne; G V Naccarelli; G T Rahilly; E N Prystowsky
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  103     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1982 May 
Date Detail:
Created Date:  1982-06-24     Completed Date:  1982-06-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  789-94     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / therapeutic use
Atrial Fibrillation / therapy
Electric Countershock*
Electrodes, Implanted
Electrophysiology
Heart Catheterization*
Heart Ventricles / physiopathology
Hemodynamics
Humans
Jugular Veins
Male
Middle Aged
Tachycardia / physiopathology,  therapy*
Ventricular Fibrillation / therapy*
Grant Support
ID/Acronym/Agency:
HL-06308/HL/NHLBI NIH HHS; HL-07182/HL/NHLBI NIH HHS; HL-18795/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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


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