Effect of Applying Force to Self-Adhesive Electrodes on Transthoracic Impedance: Implications for Electrical Cardioversion.
Background Current guidelines disagree on the role for applying force to electrodes during electrical cardioversion (ECV) for atrial fibrillation, particularly when using self-adhesive pads. We evaluated the impact of this practice on transthoracic impedance (TTI) with varying force and in individua...
| Published in: | Pacing & Clinical Electrophysiology Vol. 39; no. 10; pp. 1141 - 1148 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Oct2016
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118669178&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118669178 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Oct2016 vid: 39 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 118669178 118669178 118669178 10.1111/pace.12937 118669178 ppf: 1141 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Effect of Applying Force to Self-Adhesive Electrodes on Transthoracic Impedance: Implications for Electrical Cardioversion. aug: au: RAMIREZ, F. DANIEL FISET, SANDRA L. CLELAND, MARK J. ZAKUTNEY, TIMOTHY J. NERY, PABLO B. NAIR, GIRISH M. REDPATH, CALUM J. SADEK, MOUHANNAD M. BIRNIE, DAVID H. affil: Arrhythmia Service, University of Ottawa Heart Institute, Ottawa Ontario, Canada sug: subj: Cardiography, Impedance Cardioversion Methods Atrial Fibrillation Therapy Body Mass Index Electrodes Descriptive Statistics Data Analysis Software Wilcoxon Rank Sum Test P-Value Pearson's Correlation Coefficient Spearman's Rank Correlation Coefficient Repeated Measures Analysis of Variance Post Hoc Analysis Human Female Male Adult Middle Age Correlational Studies Research Protocols Inpatients Academic Medical Centers Canada Canada Funding Source Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background Current guidelines disagree on the role for applying force to electrodes during electrical cardioversion (ECV) for atrial fibrillation, particularly when using self-adhesive pads. We evaluated the impact of this practice on transthoracic impedance (TTI) with varying force and in individuals with differing body mass indices (BMI). We additionally assessed whether specific prompts could improve physicians' ECV technique. Methods The study comprised three parts: (1) TTI was measured in 11 participants throughout the respiratory cycle and with variable force applied to self-adhesive electrodes in anteroposterior (AP) and anterolateral (AL) configurations. (2) Three participants in different BMI classes then had TTI measured with prespecified incremental force applied. (3) Ten blinded cardiology trainees simulated ECV on one participant with and without prompting (guideline reminders and force analogies) while force applied and TTI were measured. Results The AP approach was associated with 13% lower TTI than AL (P < 0.001). Strongly negative correlations were observed between force applied and TTI in the AL position, irrespective of BMI (P ≤ 0.003). In all cases, 80% of the total reduction in TTI observed was achieved with 8 kg-force (∼80 N). All prompts resulted in significantly greater force applied and modest reductions in TTI. Conclusions Applying force to self-adhesive electrodes reduces TTI and should be considered as a means of improving ECV success. Numerically greater mean force applied with a 'push-up' force analogy suggests that 'concrete' cues may be useful in improving ECV technique. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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