Abstract | INTRODUCTION: We investigated a method of defibrillation in which two shocks were delivered to the same electrodes with a separation based on the cycle length of the fibrillation event (FCL). METHODS AND RESULTS: In pentobarbital anesthetized dogs, a computerized system determined the FCL from the fibrillation event, computed the desired double-pulse (DP) shock separation, and immediately delivered the DP shocks. In group 1, energy for 50% success at defibrillation (E50) was measured using separations from 55% to 95% of the FCL and remeasured after administration of flecainide, clofilium, or vehicle to change the FCL. Both drugs increased FCL by approximately 25%. Plots of E50 versus %FCL aligned before and after drug showed that the optimum pulse separation followed the FCL. In group 2, E50s were measured for 55% to 185% FCL separations in clofilium or vehicle-treated animals. The optimum DP E50 was at 85% FCL and was not significantly different from the single- shock E50. In group 3, no differences were found when comparing the probability of success versus total energy relationships for single and optimum DP shocks. Group 4 compared E50s for single and DP shocks using a single- catheter configuration and three- electrode configurations ( catheter-subdermal patch). E50s for single and DP shocks were equal using the single- catheter configuration but DP shocks required approximately 20% more energy in the three- electrode configurations. CONCLUSION: In single-pathway lead configurations, two shocks with 85% FCL separation can be reliably combined to defibrillate using the same total energy as a larger single shock. Since the energy is unchanged but the total duration is doubled, DP shock currents are reduced by 20% to 30%.
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Authors | R J Sweeney, R M Gill, P R Reid |
Journal | Journal of cardiovascular electrophysiology
(J Cardiovasc Electrophysiol)
Vol. 5
Issue 9
Pg. 761-70
(Sep 1994)
ISSN: 1045-3873 [Print] United States |
PMID | 7827715
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Animals
- Anti-Arrhythmia Agents
(pharmacology)
- Defibrillators, Implantable
- Dogs
- Electric Countershock
(methods)
- Electrocardiography
- Female
- Male
- Ventricular Fibrillation
(physiopathology, therapy)
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