| Short biphasic pulses from 90 microfarad capacitors lower defibrillation threshold. | |
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MedLine Citation:
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PMID: 8823832 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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For defibrillation between right ventricular and retropectoral patch electrodes using truncated exponential pulses, the stored energy defibrillation threshold (DFT) is lower for short pulses from small 60-microF capacitors than for conventional pulses from 120-microF capacitors, but 60-microF pulses frequently require higher voltages than are currently used. The goal of this study was to determine if DFT could be reduced by intermediate size 90-microF capacitors. This study compared biphasic waveform DFTs for 120 microF-65% tilt pulses, 90 microF-65% tilt pulses, and 90 microF-50% tilt pulses in 20 patients at defibrillator implantation. The 90 microF-50% tilt pulses were selected because their duration is half that of 120 microF-65% tilt pulses. The stored energy DFT for 90 microF-50% tilt pulses (9.1 +/- 4.3 J) was less than both the DFT for 120 microF-65% tilt pulses (12.0 +/- 5.5 J, P < 0.005) and the DFT for 90 microF-65% tilt pulses (11.6 +/- 5.8 J, P < 0.005). There was no significant difference between the latter two values. The voltage DFTs for 90 microF-50% pulses (436 +/- 113 V) and 120 microF-65% tilt pulses (436 +/- 104 V) were not statistically different; the voltage DFT for 90 microF-65% tilt pulses was higher than for either of the other two pulses (490 +/- 131, P < 0.005). The DFT was 20 J or greater in three patients for both 120 microF-65% tilt pulses and 90 microF-65% tilt pulses, but it was 16 J or less in all patients for 90 microF-50% tilt pulses. When pathways were dichotomized by the median resistance of 71 omega, 90 microF-50% tilt pulses significantly reduced DFTs compared to 120 microF-65% tilt pulses for higher resistance pathways (9.2 +/- 4.0 J vs 13.0 +/- 6.2 J, P = 0.002), but not lower resistance pathways (9.0 +/- 4.8 J vs 10.9 +/- 4.6 J, P = NS). For the electrode configuration tested, biphasic 90 microF-50% tilt pulses reduce stored energy DFT in comparison with 120 microF-65% tilt pulses without increasing voltage DFT. However, 90 microF-65% tilt pulses provide no benefit. |
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Authors:
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C D Swerdlow; R M Kass; S Davie; P S Chen; C Hwang |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 19 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 1996 Jul |
Date Detail:
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Created Date: 1996-12-10 Completed Date: 1996-12-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1053-60 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Defibrillators, Implantable* Electric Conductivity Electric Countershock / instrumentation, methods* Electric Power Supplies Female Humans Male Middle Aged Prospective Studies Tachycardia, Ventricular / therapy* Ventricular Fibrillation / therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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