Multiple shocks affect thoracic electrical impedance during external cardioversion of atrial fibrillation.
BACKGROUND: Thoracic impedance (TI) influences the success of external cardioversion (ECV) or defibrillation because current intensity traversing the heart is inversely related to TI. Experimental data suggest that TI decreases after multiple shocks. We undertook a clinical study to determine change...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 32; no. 3; pp. 371 - 378 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2009
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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=105475690&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105475690 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Mar2009 vid: 32 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105475690 2010221191 10.1111/j.1540-8159.2008.02246.x NLM19272068 105475690 ppf: 371 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Multiple shocks affect thoracic electrical impedance during external cardioversion of atrial fibrillation. aug: au: Fumagalli S Tarantini F Caldi F Makhanian Y Padeletti M Boncinelli L Valoti P Di Serio C Pellerito S Padeletti L Barold SS Marchionni N affil: Department of Geriatric Cardiology and Medicine, University of Florence, Viale Morgagni 85-50139, Florence, Italy; fumadue@tin.it sug: subj: Atrial Fibrillation Therapy Cardioversion Methods Electric Impedance Thorax Physiopathology Aged Amiodarone Therapeutic Use Anticoagulants Therapeutic Use Data Analysis Software Electrophysiology Heart Failure Therapy Inflammation Physiopathology Male Middle Age Human Aged: 65+ years Middle Aged: 45-64 years Male ab: BACKGROUND: Thoracic impedance (TI) influences the success of external cardioversion (ECV) or defibrillation because current intensity traversing the heart is inversely related to TI. Experimental data suggest that TI decreases after multiple shocks. We undertook a clinical study to determine changes of TI values in patients with atrial fibrillation or flutter requiring ECV. METHODS: We enrolled 222 consecutive patients (age 73 +/- 11 years; males 67%; body weight 75 +/- 13 kg) who underwent ECV between January 2004 and February 2007. Biphasic shocks were delivered through adhesive pads placed in the anteroposterior position. The initial energy was set at 1 J/kg, with progressive increases up to a maximum of 180 J in case of failure. In the last 39 elective patients, plasma concentration of interleukin-6 (IL-6) and tumor necrosis factor (TNF)-alpha were determined before and 6 hours after ECV. RESULTS: Sinus rhythm was restored in 202 patients (91.0%). Of these, 155 (69.8%) required more than one shock (on average, 2.5 +/- 1.5 shocks/patient). Final values of energy and peak current intensity were 136 +/- 47 J and 50 +/- 14 A, respectively. TI decreased significantly by 6.2% from baseline after > or =2 shocks (P < 0.001). The absolute reduction was correlated with baseline TI, number of delivered shocks, and hemoglobin oxygen saturation. IL-6 and TNF-alpha increased with ECV (P < 0.001 and P = 0.014, respectively). CONCLUSIONS: TI decreases significantly after multiple shocks, possibly by activation of acute inflammation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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