Document Detail

Efficacy of lower-energy biphasic shocks for transthoracic defibrillation: a follow-up clinical study.
MedLine Citation:
PMID:  15295725     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2004-08-05     Completed Date:  2004-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  262-7     Citation Subset:  IM    
Scripps Memorial Hospital, La Jolla, California 92037, USA.
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MeSH Terms
Aged, 80 and over
Cardiography, Impedance*
Electric Countershock / instrumentation,  methods*
Middle Aged
Prospective Studies
Sampling Studies
Treatment Outcome
Ventricular Fibrillation / physiopathology,  therapy*

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