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Low-energy defibrillation: Safe and effective

  • Carol L. Lake
    Correspondence
    Address reprint requests to Dr. Lake: Box 238, Department of Anesthesiology, University of Virginia Medical Center, Charlottesville, VA 22908.
    Affiliations
    Department of Anesthesiology, Internal Medicine (Cardiology), University of Virginia Medical Center, Charlottesville, Virginia, USA

    Department of Surgery (Thoracic and Cardiovascular), University of Virginia Medical Center, Charlottesville, Virginia, USA
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  • T.Duncan Sellers
    Affiliations
    Department of Anesthesiology, Internal Medicine (Cardiology), University of Virginia Medical Center, Charlottesville, Virginia, USA

    Department of Surgery (Thoracic and Cardiovascular), University of Virginia Medical Center, Charlottesville, Virginia, USA
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  • Stanton P. Nolan
    Affiliations
    Department of Anesthesiology, Internal Medicine (Cardiology), University of Virginia Medical Center, Charlottesville, Virginia, USA

    Department of Surgery (Thoracic and Cardiovascular), University of Virginia Medical Center, Charlottesville, Virginia, USA
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  • Ivan K. Crosby
    Affiliations
    Department of Anesthesiology, Internal Medicine (Cardiology), University of Virginia Medical Center, Charlottesville, Virginia, USA

    Department of Surgery (Thoracic and Cardiovascular), University of Virginia Medical Center, Charlottesville, Virginia, USA
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  • H.A. Wellons
    Affiliations
    Department of Anesthesiology, Internal Medicine (Cardiology), University of Virginia Medical Center, Charlottesville, Virginia, USA

    Department of Surgery (Thoracic and Cardiovascular), University of Virginia Medical Center, Charlottesville, Virginia, USA
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  • Richard S. Crampton
    Affiliations
    Department of Anesthesiology, Internal Medicine (Cardiology), University of Virginia Medical Center, Charlottesville, Virginia, USA

    Department of Surgery (Thoracic and Cardiovascular), University of Virginia Medical Center, Charlottesville, Virginia, USA
    Search for articles by this author
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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.

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