Document Detail

Evaluation of a new defibrillation pathway: tongue-epigastric/tongue-apex route. II. Impedance characteristics in human subjects.
MedLine Citation:
PMID:  6736465     Owner:  NLM     Status:  MEDLINE    
An automated device for defibrillation using a vertical shock pathway (tongue-epigastric or tongue-apex) has been developed. The energy requirements for defibrillation using vertical pathways are uncertain and will be determined largely by the impedance of the pathway. The purpose of this study was to determine the impedance characteristics of vertical defibrillation pathways in human subjects. Twenty patients undergoing elective cardioversion of atrial fibrillation or atrial flutter, or both, were studied. Patients received shocks from electrodes placed in tongue-epigastric or tongue-cardiac apex positions. The tongue electrode was a 12 cm2 metal plate fixed to a standard plastic oropharyngeal airway. The epigastric or cardiac apex electrode was a 40 cm2 self-adhesive pad. The electrodes were connected to a standard damped-sinusoidal waveform defibrillator. It was found that the two vertical shock pathways had substantially higher impedance than the standard transthoracic pathway: tongue-epigastric pathway 130 +/- 11 omega (SD), tongue-apex pathway 115 +/- 12 omega, transthoracic pathway 68 +/- 11 omega (p less than 0.05). The higher impedance is probably due to the longer interelectrode distances of vertical pathways: tongue-epigastric 33 +/- 3 cm, tongue-apex 28 +/- 3 cm, transthoracic 23 +/- 3 cm (p less than 0.05). Vertical pathway shocks were successful in the cardioversion of 15 of 20 patients. Four of the five patients in whom vertical shocks were unsuccessful subsequently underwent successful cardioversion by transthoracic shocks; the transthoracic shocks achieved a higher current because of lower impedance of the transthoracic route.(ABSTRACT TRUNCATED AT 250 WORDS)
R E Kerber; S Klein; C Kouba; A Aronson
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Publication Detail:
Type:  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:  4     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1984 Aug 
Date Detail:
Created Date:  1984-08-21     Completed Date:  1984-08-21     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:  253-8     Citation Subset:  IM    
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MeSH Terms
Atrial Fibrillation / therapy*
Atrial Flutter / therapy*
Electric Conductivity
Electric Countershock / adverse effects,  methods*
Grant Support

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