| Defibrillation efficacy of commercially available biphasic impulses in humans. Importance of negative-phase peak voltage. | |
| | |
MedLine Citation:
|
PMID: 9107169 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Recent studies have shown that specifically shaped biphasic waveforms can lower energy requirements for ventricular defibrillation. We prospectively compared the defibrillation efficacy of three different biphasic wave shapes incorporated in three commercially available implantable defibrillators. The results led to the development of a second protocol in which the importance of negative-phase peak voltage and duration was investigated. METHODS AND RESULTS: Defibrillation threshold (DFT) testing using different biphasic waveforms was performed randomly on 42 patients undergoing implantation of a cardioverter-defibrillator for ventricular arrhythmias. In 23 patients (group 1), 3 waveforms were tested: a CPI waveform with 60% positive-phase (P1) tilt and 50% negative-phase (P2) tilt, a Medtronic waveform with 65% fixed tilt in both P1 and P2, and a Ventritex waveform with 60% P1 tilt and a P2 leading edge voltage equal to half of the P1 trailing edge voltage. In 19 patients (group 2), 3 biphasic waveforms with equal P1 tilt at 65% but shorter P2 duration or smaller P2 peak voltage were tested. The Endotak C 60 series lead system (CPI) was used in 11 patients in group 1 and 10 patients in group 2. A Transvene lead system (Medtronics) was used in the remaining patients. Stored energy required for defibrillation was significantly lower with the CPI waveform compared with the Ventritex waveform. In group 2, energy requirements were significantly increased for the waveform with a smaller P2 peak voltage, whereas a short P2 duration did not influence defibrillation success. CONCLUSIONS: Our results suggest that specifically shaped biphasic waveforms delivered from commercially available devices can affect energy requirements for defibrillation. More importantly, the amplitude of the P2 peak voltage may be a more critical determinant than the P2 duration for defibrillation success of biphasic waveforms in humans. |
| | |
Authors:
|
G Tomassoni; K Newby; S Deshpande; K Axtell; J Sra; M Akhtar; A Natale |
Related Documents
:
|
10598969 - Initial clinical experience with a fully automatic in-hospital external cardioverter de... 7770359 - The left subclavian vein as an alternative site for implantation of the second defibril... 6843409 - Effects of myocardial infarction on catheter defibrillation threshold. 480559 - Energy levels and patient weight in ventricular defibrillation. 1876269 - Parasympathetic control of the spontaneous defibrillation of the heart ventricles in an... 10089869 - The atrial defibrillator: a stand-alone device or part of a combined dual-chamber system? 7121779 - Overall management of vascular lesions considered treatable with extracranial-intracran... 1718689 - Calcium antagonists and myocardial microperfusion. 20927269 - Dynamic left ventricular outflow tract obstruction complicating aortic valve replacemen... |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article |
Journal Detail:
|
Title: Circulation Volume: 95 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Apr |
Date Detail:
|
Created Date: 1997-05-13 Completed Date: 1997-05-13 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1822-6 Citation Subset: AIM; IM |
Affiliation:
|
Electrophysiology Laboratory, Duke University, VA Medical Center, Durham, NC 27705, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Defibrillators, Implantable* Electric Countershock / instrumentation* Electric Impedance Equipment Design Female Humans Male Middle Aged Prospective Studies Tachycardia, Ventricular / therapy Ventricular Fibrillation / therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Origin of respiratory sinus arrhythmia in conscious humans. An important role for arterial carotid b...
Next Document: Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pr...