Document Detail


Prospective randomized comparison of anodal monophasic shocks versus biphasic cathodal shocks on defibrillation energy requirements.
MedLine Citation:
PMID:  8615317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Biphasic shocks are believed to be superior to monophasic shocks. Monophasic anodal shocks, as opposed to cathodal shocks, are associated with improved defibrillation energy requirements (DERs). However, it is unclear how the DER of anodal monophasic shocks compare with conventional biphasic shocks. Therefore the purpose of this study was to prospectively compare the DER of an anodal monophasic shock with that of a cathodal biphasic shock. A transvenous defibrillation lead with distal and proximal shocking electrodes was used. The subjects of this study were 20 consecutive patients with a mean age of 64.2 +/- 10.5 years ( +/- SD) and a mean left ventricular ejection fraction of 0.36 +/- 0.18. Six had had cardiac arrest. The DER, defined as the lowest energy that converted ventricular fibrillation to sinus rhythm, was determined twice with a step-down protocol (25 J, 20 J, 15 J, 10 J, 5 J, 3 J, 1 J). If the DER was > or = 25 J, then a subcutaneous patch was deemed necessary for system implantation. In random order the DER was determined with a monophasic anodal shock (distal electrode positive) and then with a cathodal (first phase, distal electrode negative) biphasic shock. The mean DER with anodal monophasic shocks was 15.1 +/- 8.5 J compared with 13.6 +/- 8.1 J with cathodal biphasic shocks (p = 0.4). A DER > or = 25 J was present in three patients with the monophasic waveform and in three patients with the biphasic waveform (p = NS). In conclusion, the DER and frequency of subcutaneous patch use with an anodal monophasic waveform is comparable to that obtained with cathodal biphasic waveform.
Authors:
S A Strickberger; E Daoud; R Goyal; K K Chan; F Bogun; M Castellani; M Harvey; L E Horwood; M Niebauer; K C Man; F Morady
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  131     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-06-05     Completed Date:  1996-06-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  961-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Michigan Medical Center 48109-0022, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathy, Dilated / therapy*
Coronary Disease / therapy*
Defibrillators, Implantable*
Electric Countershock / instrumentation,  methods*
Electrodes, Implanted
Female
Humans
Male
Middle Aged
Prospective Studies
Tachycardia, Ventricular / therapy

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


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