Document Detail

Treatment of intractable ventricular fibrillation with prompt circulatory support using a biventricular assist device in pigs--an experimental study.
MedLine Citation:
PMID:  1631868     Owner:  NLM     Status:  MEDLINE    
Refractory ventricular fibrillation (VF), intractable to conventional therapy, can be converted into a stable cardiac rhythm by immediate ventricular volume unloading using a form of mechanical circulatory assist (MCA). We investigated the efficacy of MCA in a controlled animal study in which 20 pigs were subjected to intermittent occlusions (5 times) of the left descending coronary artery (5 min. occlusion + 10 min. reperfusion). 12 of the 20 animals (60%) developed 14 events of VF. 64% of VF developed during reperfusion (p less than 0.05). Countershock was attempted up to eight times and was successful in 5 of the 14 events (36%) (primary defibrillation, PD). When conversion was not achieved, total biventricular bypass was instituted. Mean perfusion time between countershock attempts was 24.4 +/- 15.3 min. All animals (n = 9) with cardiac assistance were successfully defibrillated (secondary defibrillation, SD), (p less than 0.05). Hemodynamic parameters after SD were not significantly different from those after PD (p greater than 0.05). Survival rate following PD was 66.6%. Six animals were ultimately weaned from cardiac assistance following SD. Three others died of progressive cardiogenic shock in the six hour follow-up period following SD. These non-survivors had a significantly longer VF time than the survivors (41.7 +/- 10.4 vs. 15.8 +/- 8.0, p less than 0.05). Overall survival after SD was the same as that for PD: 66.6% (p greater than 0.05). These results show that prompt conversion of VF into a stable cardiac rhythm is a prerequisite to recovery.(ABSTRACT TRUNCATED AT 250 WORDS)
R Tukkie; P F Gründeman; A C Moulijn; V J Rudolphy; P J Klopper
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  40     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  1992 Feb 
Date Detail:
Created Date:  1992-08-18     Completed Date:  1992-08-18     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  5-9     Citation Subset:  IM    
Department of Experimental Surgery, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Electric Countershock
Heart-Assist Devices*
Myocardial Infarction / complications
Myocardial Reperfusion Injury / complications
Shock, Cardiogenic / etiology,  mortality
Ventricular Fibrillation / complications,  etiology,  therapy*

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