| A randomized controlled trial of efficacy and ST change following use of the Welch-Allyn MRL PIC biphasic waveform versus damped sine monophasic waveform for external DC cardioversion. | |
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MedLine Citation:
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PMID: 16987583 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Biphasic waveforms have similar or greater efficacy at cardioverting atrial and ventricular arrhythmias at lower energy levels than monophasic waveforms, and cause less ST depression following defibrillation of ventricular fibrillation. No studies have investigated this effect on ST change with atrial arrhythmias. We studied the efficacy of the Welch Allyn-MRL PIC biphasic defibrillator. METHODS: One hundred and thirty-nine patients undergoing elective DC cardioversion for atrial arrhythmias were randomised to cardioversion by monophasic (Hewlett Packard Codemaster XL; 100, 200, 300, 360 and 360J) or biphasic (Welch Allyn-MRL PIC; 70, 100, 150, 200 and 300J) defibrillator. We analysed success of cardioversion after 0 and 30min, cumulative energy, number of shocks and energy at successful cardioversion. The ST change in the recorded electrocardiogram was measured at 15s after all shocks using electronic callipers. RESULTS: Immediately after cardioversion 59/68 (86.8%) of the monophasic group versus 56/60 (93.3%) of the biphasic group were in sinus rhythm. Of the monophasic group, 55/67 (82.1%) remained in sinus rhythm at 30min versus 53/58 (91.4%) of the biphasic group. These differences were not significant at 0min (P=0.35) or 30min (P=0.21). The biphasic group required significantly fewer shocks (P=0.006), less cumulative energy (P<0.0001) and required lower total energy for successful cardioversion (P<0.0001). Of the 102 patients with electrocardiogram recordings suitable for analysis, ST segment change was greater in the monophasic group (P=0.037). CONCLUSIONS: The Welch Allyn-MRL biphasic waveform for DC cardioversion results in fewer shocks, with less cumulative energy delivered and less post shock ST change than with a Hewlett Packard Codemaster XL damped sine wave monophasic waveform. |
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Authors:
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Jonathan J S Ambler; Charles D Deakin |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2006-09-20 |
Journal Detail:
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Title: Resuscitation Volume: 71 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-10-27 Completed Date: 2007-02-05 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 146-51 Citation Subset: IM |
Affiliation:
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Shackleton Department of Anaesthetics, Southampton University Hospitals NHS Trust, Southampton SO16 6YD, UK. jjsa@amblers.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Arrhythmias, Cardiac / therapy* Double-Blind Method Electric Countershock / instrumentation*, methods* Electrocardiography* Female Humans Male Middle Aged Outcome Assessment (Health Care) Prospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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