Document Detail

Double and triple sequential shocks reduce ventricular defibrillation threshold in dogs with and without myocardial infarction.
MedLine Citation:
PMID:  3782643     Owner:  NLM     Status:  MEDLINE    
The role of optimal placement of electrodes and mode of shock delivery from a defibrillator was examined in dogs with and without myocardial infarction. Single, double and triple truncated exponential shocks separated by 1 ms were delivered through various electrode combinations and cardiac vectors after electrical induction of ventricular fibrillation. A single shock through a pathway not incorporating the interventricular septum (catheter electrodes or epicardial patches between anterior and posterior left ventricle) required the highest total energy (22.6 and greater than 26.4 J, respectively) and peak voltage (1,004 and greater than 1,094 V, respectively) to terminate ventricular fibrillation. A single shock through a pathway including the interventricular septum required lower total energy and peak voltage to defibrillate. Combinations of two sequential shocks between an intracardiac catheter electrode and anterior left ventricular epicardial patch, between the catheter electrode and subcutaneous extrathoracic plate and between three ventricular epicardial patches all significantly reduced total energy (7.7, 8.7 and 7.8 J, respectively) and peak voltage (424, 436 and 424 V, respectively) needed to defibrillate. Three sequential shocks exerted no significant additional reduction in total energy of the defibrillation threshold than did two sequential shocks. Infarcted canine heart required less peak voltage but not total energy to terminate ventricular fibrillation than did noninfarcted heart. Therefore, two sequential shocks over different pathways reduce both total energy and peak voltage required to terminate ventricular fibrillation.
M S Chang; H Inoue; M J Kallok; D P Zipes
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  8     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1986 Dec 
Date Detail:
Created Date:  1987-01-05     Completed Date:  1987-01-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1393-405     Citation Subset:  AIM; IM    
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MeSH Terms
Body Weight
Differential Threshold
Electric Conductivity
Electric Countershock / methods*
Myocardial Infarction / complications,  physiopathology*
Ventricular Fibrillation / complications,  therapy*
Grant Support

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

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