Document Detail


The effects of biphasic and conventional monophasic defibrillation on postresuscitation myocardial function.
MedLine Citation:
PMID:  10483965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to compare the effects of biphasic defibrillation waveforms and conventional monophasic defibrillation waveforms on the success of initial defibrillation, postresuscitation myocardial function and duration of survival after prolonged ventricular fibrillation (VF). BACKGROUND: We have recently demonstrated that the severity of postresuscitation myocardial dysfunction was closely related to the magnitude of the electrical energy of the delivered defibrillation shock. In the present study, the effects of fixed 150-J low-energy biphasic waveform shocks were compared with conventional monophasic waveform shocks after prolonged VF. METHODS: Twenty anesthetized, mechanically ventilated domestic pigs were investigated. VF was induced with an AC current delivered to the right ventricular endocardium. After either 4 or 7 min of untreated ventricular fibrillation (VF), the animals were randomized for attempted defibrillation with up to three 150-J biphasic waveform shocks or conventional sequence of 200-, 300- or 360-J monophasic waveform shocks. If VF was not reversed, a 1-min interval of precordial compression preceded a second sequence of up to three shocks. The protocol was repeated until spontaneous circulation was restored or for a total of 15 min. RESULTS: Monophasic waveform defibrillation after 4 or 7 min of untreated VF resuscitated eight of 10 pigs. All 10 pigs treated with biphasic waveform defibrillation were successfully resuscitated. Transesophageal echo-Doppler, arterial pressure and heart rate measurements demonstrated significantly less impairment of cardiovascular function after biphasic defibrillation. CONCLUSIONS: Lower-energy biphasic waveform shocks were as effective as conventional higher energy monophasic waveform shocks for restoration of spontaneous circulation after 4 and 7 min of untreated VF. Significantly better postresuscitation myocardial function was observed after biphasic waveform defibrillation.
Authors:
W Tang; M H Weil; S Sun; H Yamaguchi; H P Povoas; A M Pernat; J Bisera
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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:  Journal of the American College of Cardiology     Volume:  34     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-09-24     Completed Date:  1999-09-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  815-22     Citation Subset:  AIM; IM    
Affiliation:
The Institute of Critical Care Medicine, Palm Springs, California 92262-5309, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Electric Countershock / instrumentation,  methods*,  statistics & numerical data
Heart / physiopathology*
Heart Arrest / physiopathology,  therapy
Hemodynamics
Random Allocation
Resuscitation / instrumentation,  methods*,  statistics & numerical data
Swine
Time Factors
Ventricular Fibrillation / physiopathology,  therapy
Grant Support
ID/Acronym/Agency:
HL-54322/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2001 May;37(6):1753-4   [PMID:  11345396 ]

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