Document Detail


Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment.
MedLine Citation:
PMID:  3359585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purposes of this study were two. First, we wanted to evaluate in patients a technique for automated adjustment of selected energy for defibrillation or cardioversion based on transthoracic impedance. Second, we wanted to define the relationship of peak current and shock success in various arrhythmias. Applying a previously validated method of predicting transthoracic impedance in advance of any shock, we modified defibrillators to automatically double the operator-selected energy if the predicted impedance exceeded 70 omega. Success rates of shocks given for ventricular and atrial arrhythmias from these modified energy-adjusting defibrillators were compared with success rates for shocks given from standard defibrillators. We prospectively collected data on 347 patients who received a total of 1009 shocks. Low-energy (100 J) shocks given to high-impedance (greater than or equal to 70 omega) patients had a poor success rate; in such high-impedance patients significant improvement in shock success rate was achieved by the energy-adjusting defibrillators. For example, when 100 J shocks were selected for high-impedance patients in ventricular fibrillation the energy-adjusting defibrillators achieved a shock success rate of 75%, whereas standard defibrillators achieved a shock success rate of only 36% (p less than .01). Similar improvements were seen for ventricular tachycardia and atrial fibrillation. Thus, automated energy adjustment based on transthoracic impedance is a beneficial approach to defibrillation and cardioversion. For ventricular fibrillation, atrial fibrillation, and atrial flutter there was a clear relationship between peak current and shock success.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R E Kerber; J B Martins; M G Kienzle; L Constantin; B Olshansky; R Hopson; F Charbonnier
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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:  Circulation     Volume:  77     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1988 May 
Date Detail:
Created Date:  1988-06-03     Completed Date:  1988-06-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1038-46     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Division, University of Iowa, Iowa City.
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / physiopathology,  therapy
Electric Conductivity
Electric Countershock / instrumentation,  methods*
Emergencies
Evaluation Studies as Topic
Humans
Prospective Studies
Grant Support
ID/Acronym/Agency:
HL-14388/HL/NHLBI NIH HHS

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


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