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Abstract
During cardiopulmonary bypass, 150 cardiac surgical patients were prospectively evaluated
for the number, energy, current, and success rates of direct current (DC) shocks required
to terminate reperfusion ventricular fibrillation (1°) or ventricular fibrillation
occurring subsequent to a nonfibrillatory reperfusion rhythm (2°). Thirty-one percent
of 1-J shocks and 58% of 2.5-J shocks defibrillated. Above 2.5 J, the defibrillation
success rate reached a plateau of 50–60%. Myocardial resistance decreased significantly
after the first shock but remained stable during subsequent shocks. Lower defibrillating
currents and myocardial resistances than had been previously reported were observed.
The feasibility of low-energy defibrillation during cardiopulmonary bypass was therefore
documented.
Keywords
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References
- Accepted, controversial, and speculative aspects of ventricular defibrillation.Prog Cardiovasc Dis. 1980; 23: 167-185
- The electrical dose for direct ventricular defibrillation in man.J Thorac Cardiovasc Surg. 1978; 75: 224-226
- Low energy electrical defibrillation of human hearts during cardiac surgery.J Thorac Cardiovasc Surg. 1974; 68: 603-605
- Low energy direct defibrillation of the human heart.Ann Thorac Surg. 1979; 27: 32-33
- Open chest defibrillation during cardiac surgery: Energy and current requirements.Am J Cardiol. 1980; 46: 393-396
- Termination of ventricular fibrillation in dogs by depolarizing a critical amount of myocardium.Am J Cardiol. 1975; 36: 37-44
- Energy dose and other variables possibly affecting ventricular defibrillation during cardiac surgery.Anesth Analg. 1984; 63: 743-751
- Human transventricular defibrillation threshold.in: Proceedings of the AAMI 16th Annual Meeting: Association for the Advancement of Medical Instrumentation. 1981: 8
- Determinants of intracardiac current in defibrillation.Circulation. 1981; 64: 818-823
- Cardiac damage produced by direct current countershock applied to the heart.Am J Cardiol. 1979; 43: 225-232
- ischemic ventricular defibrillation: The importance of being spontaneous.Am J Cardiol. 1981; 48: 455-459
- Effect of acute myocardial ischemia and left ventricular hypertrophy on energy requirement for defibrillation of closed chest dogs.Circulation. 1981; 64: 188
- Efficacy and safety of defibrillation with rectangular waves of 2- to 20-milliseconds duration.Crit Care Med. 1983; 11: 95-98
- Experimental and clinical application of DC defibrillation: Perceptions and problems.Med Instrum. 1978; 12: 55
- Transchest ventricular defibrillation of heavy subjects using trapezoidal current waveforms.J Electrocardiol. 1975; 8: 237-240
- Transthoracic resistance in human defibrillation: Influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure.Circulation. 1981; 63: 676-682
- Effect of direct-current countershock on regional myocardial contractility and perfusion.Circulation. 1981; 63: 323-332
- Cardiac arrest and resuscitation: Defibrillators and defibrillation.Curr Probs Cardiol. 1978; 2: 1-71
- High energy electrical current and myocardial damage.Med Instrum. 1978; 12: 24-26
- The effects of shock energy, propranolol, and verapamil on cardiac damage caused by transthoracic countershock.Circulation. 1984; 69: 357-368
Article Info
Publication History
Accepted:
September 24,
1984
Received:
September 5,
1984
Footnotes
☆Supported by NIH grant no. 25919 and by Physio Control Corporation, Redmond, Washington.
☆☆Presented in part at the Fifth Purdue Conference on CPR and Defibrillation, West Lafayette, Indiana, September 25–26, 1984, and at the International Anesthesia Research Society meeting, New Orleans, Louisiana, March 15, 1983.
Identification
Copyright
© 1985 Published by Elsevier Inc.
