Changes in the amplitude of endocardial electrograms following defibrillator discharge: comparison of two lead systems.
Changes in the amplitude of endocardial electrograms after an unsuccessful shock attempt have been demonstrated to cause failure of redetection of ventricular fibrillation in patients using an integrated sense-pace defibrillating lead system. Thus, the objective of this study was to compare the effe...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 18; no. 12; pp. 2163 - 2173 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Dec1995
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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=106038274&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106038274 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Dec1995 vid: 18 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106038274 2009414179 NLM8771129 106038274 ppf: 2163 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Changes in the amplitude of endocardial electrograms following defibrillator discharge: comparison of two lead systems. aug: au: Jung W Manz M Moosdorf R Tebbenjohanns J Pfeiffer D Lüderitz B sug: ab: Changes in the amplitude of endocardial electrograms after an unsuccessful shock attempt have been demonstrated to cause failure of redetection of ventricular fibrillation in patients using an integrated sense-pace defibrillating lead system. Thus, the objective of this study was to compare the effects of defibrillator shocks on the amplitude of endocardial electrograms in 26 patients using two different nonthoracotomy systems, a previous lead (model 0062) or a redesigned version (model 0072). At implant, bipolar endocardial electrograms were obtained before each shock application, during initial detection and redetection of ventricular fibrillation in case the applied shock was unsuccessful, and during intervals of 5, 10, 20, 30, 60, and 120 seconds after each shock delivery. No significant difference was noted in endocardial amplitudes between the lead models 0062 and 0072 during baseline sinus rhythm (12.2 ± 4.6 mV vs 11.4 ± 3.8 mV), and during initial ventricular fibrillation (7.0 ± 2.4 mV vs 7.6 ± 2.3 mV). During redetection of ventricular fibrillation, however, there was a significant difference (P = 0.0006) in endocardial amplitudes (3.4 ± 1.9 mV vs 6.6 ± 2.3 mV) between both leads tested. Comparing lead models 0062 and 0072, marked differences were found in endocardial amplitudes during sinus rhythm 5, 10, and 20 seconds after successful arrhythmia termination: 2.8 ± 1.9 mV vs 8.6 ± 2.9 mV(P < 0.0001), 4.6 ± 2.9 mV vs 9.2 ± 3.2 mV(P = 0.0007), and 6.4 ± 4.0 mV vs 10.5 ± 3.6 mV (P = 0.01). At predischarge testing, failure of redetection of ventricular fibrillation was documented in two patients with the lead model 0062 requiring external defibrillation to restore sinus rhythm. These findings demonstrate a significant less postshock attenuation of the endocardial electrogram amplitudes during persistent ventricular fibrillation after an unsuccessful shock attempt as well as during sinus rhythm immediately following an effective shock delivery using the redesigned lead system model 0072 compared to the electrogram amplitudes obtained in patients using the previous lead model 0062. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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