| The effects of biphasic waveform design on post-resuscitation myocardial function. | |
| | |
MedLine Citation:
|
PMID: 15063435 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: This study examined the effects of biphasic truncated exponential waveform design on survival and post-resuscitation myocardial function after prolonged ventricular fibrillation (VF). BACKGROUND: Biphasic waveforms are more effective than monophasic waveforms for successful defibrillation, but optimization of energy and current levels to minimize post-resuscitation myocardial dysfunction has been largely unexplored. We examined a low-capacitance waveform typical of low-energy application (low-energy biphasic truncated exponential [BTEL]; 100 microF, < or =200 J) and a high-capacitance waveform typical of high-energy application (high-energy biphasic truncated exponential [BTEH]; 200 microF, > or =200 J). METHODS: Four groups of anesthetized 40- to 45-kg pigs were investigated. After 7 min of electrically induced VF, a 15-min resuscitation attempt was made using sequences of up to three defibrillation shocks followed by 1 min of cardiopulmonary resuscitation. Animals were randomized to BTEL at 150 J or 200 J or to BTEH at 200 J or 360 J. RESULTS: Resuscitation was unsuccessful in three of the five animals treated with BTEH at 200 J. All other attempts were successful. Significant therapy effects were observed for survival (p = 0.035), left ventricular ejection fraction (p < 0.001), stroke volume (p < 0.001), fractional area change (p < 0.001), cardiac output (p = 0.044), and mean aortic pressure (p < 0.001). Hemodynamic outcomes were negatively associated with energy and average current but positively associated with peak current. Peak current was the only significant predictor of survival (p < 0.001). CONCLUSIONS: Maximum survival and minimum myocardial dysfunction were observed with the low-capacitance 150-J waveform, which delivered higher peak current while minimizing energy and average current. |
| | |
Authors:
|
Wanchun Tang; Max Harry Weil; Shijie Sun; Dawn Jorgenson; Carl Morgan; Kada Klouche; David Snyder |
Related Documents
:
|
12941205 - Icd therapy for the prevention of sudden cardiac death in post-mi patients. 14720165 - Cardioverter defibrillator implantation in a child with isolated noncompaction of the v... 3354705 - A new fabrication technique for directly coupled transmural cardiac electrodes. 3894475 - The automatic implantable cardioverter-defibrillator: an overview. 8890805 - Expression of polymorphonuclear leukocyte adhesion molecules and its clinical significa... 3677355 - Neodymium:yag laser photocoagulation: a successful new map-guided technique for the int... |
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: 43 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2004 Apr |
Date Detail:
|
Created Date: 2004-04-05 Completed Date: 2004-05-25 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: 1228-35 Citation Subset: AIM; IM |
Affiliation:
|
Insitute of Critical Care Medicine, Palm Springs, California 92262-5309, USA. drsheart@aol.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Cardiopulmonary Resuscitation* Disease Models, Animal Electric Countershock High-Energy Shock Waves / therapeutic use* Male Models, Cardiovascular Myocardium / pathology* Swine Treatment Outcome Ventricular Fibrillation / physiopathology, therapy |
| Grant Support | |
ID/Acronym/Agency:
|
R01HL 54322/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Economic analysis of a transesophageal echocardiography-guided approach to cardioversion of patients...
Next Document: The prognostic significance of exercise-induced atrial arrhythmias.