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- Title
The Probability of Defibrillation Success and the Incidence of Postshock Arrhythmia as a Function of Shock Strength.
- Authors
Gates, Adam W.; Wolf, Patrick D.; Hillsley, Russell E.; Souza, Joseph J.; Smith, William M.; Ideker, Raymond E.
- Abstract
The effects of high voltage defibrillation shocks given to six swine were studied to determine if there is a limit to the advantage gained from increasing the shock strength. An endocardial electrode was placed in the right ventricle, and a 114-cm² cutaneous patch was placed on the left lateral thorax. Monophasic (10 msec) and single capacitor biphosic (5/5 msec) shocks with leading edge voltages of 200, 400, 600, 800, and 990 volts (approximately 2.3-59 J) were tested. For monophasic shocks, the probability of successful defibrillation ranged from 0% at 200 V to 90% at 990 V. The incidence of postshock arrhythmia increased from 0% for successful shocks at 600 V to 67% for successful shocks at 990 V. For biphasic shocks, the probability of success peaked at 97% for the 600-, 800-, and 990-V shocks. The incidence of postshock arrhythmia increased from 8% at 400 V to 55% at 990 V. Although more postshock arrhythmias occurred at lower strengths for biphasic than for monophasic shocks, an efficacy criterion, quantifying the probability of defibrillation success acid the probability that a postshock arrhythmia will not occur, was always higher for biphasic shocks. The probability of success never reached 100% for either waveform while the incidence of postshock arrhythmia increased as the shock strength increased. In conclusion, for the catheter-patch electrode configuration, increasing the shock strength does not always improve the probability of success and may increase the incidence of postshock arrhythmia.
- Subjects
ELECTRIC countershock; CARDIAC resuscitation; ARRHYTHMIA; ELECTRODES; RIGHT heart ventricle; ELECTROTHERAPEUTICS
- Publication
Pacing & Clinical Electrophysiology, 1994, Vol 17, Issue 7, p1208
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1994.tb01487.x