| Efficacy of lower-energy biphasic shocks for transthoracic defibrillation: a follow-up clinical study. | |
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MedLine Citation:
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PMID: 15295725 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This clinical study prospectively evaluated the first-shock defibrillation efficacy of 150-joule impedance-compensated, 200-microF biphasic truncated exponential (BTE) shocks in patients with electrically-induced ventricular fibrillation (VF), and compared it with a historical control group treated with 200-J monophasic damped sine (MDS) shocks. METHODS: Ventricular tachyarrhythmias were induced in patients undergoing electrophysiologic (EP) testing for ventricular arrhythmias or testing of an implantable cardioverter-defibrillator (ICD). A 150-J shock was delivered as the primary therapy to terminate induced arrhythmias in the EP group, and as a "rescue" shock when a single ICD shock failed to terminate the arrhythmias in the ICD group. RESULTS: Ninety-six patients received study shocks. The preshock rhythm was classified as VF in 77 patients and as ventricular tachycardia (VT) in 19 patients. First-shock success rates for VF and VT were 75 out of 77 (97.4%) and 19 out of 19 (100%) for the 150-J BTE compared with the historical control rates of 61 out of 68 (89.7%) and 29 out of 31 (94%) for 200-J MDS. The first-shock success rate for VF treated with 150-J BTE was technically equivalent to that of 200-J MDS (p=0.001). The transthoracic impedance did not vary between groups, yet the peak current delivered by the 150-J BTE shock was about 50% lower. CONCLUSIONS: This study demonstrated that 150-J shocks of this impedance-compensated, 200-microF BTE waveform provided very high efficacy for defibrillation of short duration, electrically-induced VF. These lower-energy biphasic shocks had a success rate equivalent to that of 200-J MDS shocks, and they provided this efficacy while exposing patients to much less current than the monophasic shocks. |
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Authors:
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Steven L Higgins; Sharon G O'Grady; Isabelle Banville; Fred W Chapman; Paul W Schmitt; Paula Lank; Robert G Walker; Marina Ilina |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors Volume: 8 ISSN: 1090-3127 ISO Abbreviation: Prehosp Emerg Care Publication Date: 2004 Jul-Sep |
Date Detail:
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Created Date: 2004-08-05 Completed Date: 2004-10-07 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9703530 Medline TA: Prehosp Emerg Care Country: United States |
Other Details:
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Languages: eng Pagination: 262-7 Citation Subset: IM |
Affiliation:
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Scripps Memorial Hospital, La Jolla, California 92037, USA. epdoc@cardiacarrhythmia.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cardiography, Impedance* Electric Countershock / instrumentation, methods* Female Humans Male Middle Aged Prospective Studies Sampling Studies Treatment Outcome Ventricular Fibrillation / physiopathology, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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