Selecting the transthoracic defibrillation shock directional vector based on VF amplitude improves shock success.
Introduction: Termination of ventricular fibrillation (VF) by a defibrillating shock is more likely to occur when the VF amplitude is larger. We hypothesized that a defibrillation shock would achieve higher success if the shock vector was oriented along the largest of the VF amplitudes measured simu...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 20; no. 9; pp. 1032 - 1039 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105418779&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105418779 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Sep2009 vid: 20 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105418779 2010386265 10.1111/j.1540-8167.2009.01483.x NLM19460079 105418779 ppf: 1032 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Selecting the transthoracic defibrillation shock directional vector based on VF amplitude improves shock success. aug: au: Brooks L Zhang Y Dendi R Anderson RH Zimmerman B Kerber RE affil: Cardiovascular Center, College of Medicine, University of Iowa, Iowa City, Iowa, USA sug: subj: Defibrillation Methods Quality of Health Care Resuscitation, Cardiopulmonary Ventricular Fibrillation Prevention and Control Animal Studies Confidence Intervals Electrocardiography Funding Source Iowa Odds Ratio Swine ab: Introduction: Termination of ventricular fibrillation (VF) by a defibrillating shock is more likely to occur when the VF amplitude is larger. We hypothesized that a defibrillation shock would achieve higher success if the shock vector was oriented along the largest of the VF amplitudes measured simultaneously in 3 orthogonal ECG leads, and that this axis could be determined near-instantaneously in real time. Methods and Results: In 9 closed-chest anesthetized swine, a new directional defibrillation (DD) device was used to simultaneously measure the VF peak amplitudes displayed by 3 orthogonal pairs of defibrillation electrodes: anterior-posterior, lateral-lateral, and superior-inferior. Four shocks at each of 3 energy levels (30 Joules [J], 50 J, and 100 J) were delivered through the electrode pair measuring the largest (LA) and smallest (SA) VF peak amplitude at the time of the shock. The odds of shock success (VF termination followed by a perfusing rhythm) were 5 times more likely when shocks were delivered from the LA electrodes than the SA electrodes (odds ratio 5.10, 95% CI: 1.39, 18.79). At the intermediate energy level of 50 J, shocks delivered through the LA electrode pairs had an almost 9 times higher odds of shock success than 50 J shocks delivered through the SA electrode pairs (68.3% vs 18.9%, P = 0.002) (odds ratio 8.94, 95% CI: 2.59, 30.82). Transthoracic impedance and current did not differ for shocks delivered in the LA versus SA groups. Conclusion: Choosing the defibrillation directional vector based on the largest VF amplitude improved shock success. pubtype: Academic Journal doctype: research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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