DOUBLE SEQUENTIAL EXTERNAL SHOCKS FOR REFRACTORY VENTRICULAR-FIBRILLATION

被引:63
作者
HOCH, DH [1 ]
BATSFORD, WP [1 ]
GREENBERG, SM [1 ]
MCPHERSON, CM [1 ]
ROSENFELD, LE [1 ]
MARIEB, M [1 ]
LEVINE, JH [1 ]
机构
[1] YALE NEW HAVEN MED CTR,DEPT CARDIOL,NEW HAVEN,CT 06504
关键词
D O I
10.1016/0735-1097(94)90602-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. A technique for terminating refractory ventricular fibrillation is described. Background. Refractory ventricular fibrillation can occur in up to 0.1% of electrophysiologic studies. Animal studies have shown that rapid sequential shacks may reduce ventricular fibrillation threshold. Methods. Five patients of 2,990 consecutive patients in a 3-year period experienced refractory ventricular fibrillation during 5,450 routine electrophysiologic studies. Multiple shocks were delivered by means of a single defibrillator. Double sequential shocks were delivered externally 0.5 to 4.5 s apart by means of two defibrillators with separate pairs of electrodes. Results. In all patients, standard defibrillation was unsuccessful, but all were successfully resuscitated using the double sequential shocks. Conclusions. This report stresses the importance of an additional defibrillator being readily available during electrophysiologic testing. This technique of rapid, double sequential external shocks may have general applicability, providing a simple and potentially lifesaving approach to refractory ventricular fibrillation.
引用
收藏
页码:1141 / 1145
页数:5
相关论文
共 27 条
[1]   PROSPECTIVE COMPARISON OF SEQUENTIAL PULSE AND SINGLE PULSE DEFIBRILLATION WITH USE OF 2 DIFFERENT CLINICALLY AVAILABLE SYSTEMS [J].
BARDY, GH ;
IVEY, TD ;
ALLEN, MD ;
JOHNSON, G ;
GREENE, HL .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 14 (01) :165-171
[2]   DOUBLE AND TRIPLE SEQUENTIAL SHOCKS REDUCE VENTRICULAR DEFIBRILLATION THRESHOLD IN DOGS WITH AND WITHOUT MYOCARDIAL-INFARCTION [J].
CHANG, MS ;
INOUE, H ;
KALLOK, MJ ;
ZIPES, DP .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1986, 8 (06) :1393-1405
[3]   EMERGENCY INTRACARDIAC DEFIBRILLATION FOR REFRACTORY VENTRICULAR-FIBRILLATION DURING ROUTINE ELECTROPHYSIOLOGIC STUDY [J].
COHEN, TJ ;
SCHEINMAN, MM ;
PULLEN, BT ;
CHIESA, NA ;
GONZALEZ, R ;
HERRE, JM ;
GRIFFIN, JC .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (05) :1280-1284
[4]   COMPLICATIONS IN PATIENTS UNDERGOING CARDIAC ELECTROPHYSIOLOGIC PROCEDURES [J].
DIMARCO, JP ;
GARAN, H ;
RUSKIN, JN .
ANNALS OF INTERNAL MEDICINE, 1982, 97 (04) :490-493
[5]   SUCCESS OF CHRONIC DEFIBRILLATION AND THE ROLE OF ANTIARRHYTHMIC DRUGS WITH THE AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATOR [J].
GUARNIERI, T ;
LEVINE, JH ;
VELTRI, EP ;
GRIFFITH, LSC ;
WATKINS, L ;
JUANTEGUY, J ;
MOWER, MM ;
MIROWSKI, M .
AMERICAN JOURNAL OF CARDIOLOGY, 1987, 60 (13) :1061-1064
[6]   IF NOTHING GOES WRONG, IS EVERYTHING ALL RIGHT - INTERPRETING ZERO NUMERATORS [J].
HANLEY, JA ;
LIPPMANHAND, A .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1983, 249 (13) :1743-1745
[7]  
HOROWITZ LN, 1986, CIRCULATION, V73, P28
[8]   EFFECT OF PULSE SEPARATION BETWEEN 2 SEQUENTIAL BIPHASIC SHOCKS GIVEN OVER DIFFERENT LEAD CONFIGURATIONS ON VENTRICULAR DEFIBRILLATION EFFICACY [J].
JOHNSON, EE ;
ALFERNESS, CA ;
WOLF, PD ;
SMITH, WM ;
IDEKER, RE .
CIRCULATION, 1992, 85 (06) :2267-2274
[9]   INTERNAL CARDIAC DEFIBRILLATION - SINGLE AND SEQUENTIAL PULSES AND A VARIETY OF LEAD ORIENTATIONS [J].
JONES, DL ;
KLEIN, GJ ;
RATTES, MF ;
SOHLA, A ;
SHARMA, AD .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1988, 11 (05) :583-591
[10]   INTERNAL CARDIAC DEFIBRILLATION IN MAN - PRONOUNCED IMPROVEMENT WITH SEQUENTIAL PULSE DELIVERY TO 2 DIFFERENT LEAD ORIENTATIONS [J].
JONES, DL ;
KLEIN, GJ ;
GUIRAUDON, GM ;
SHARMA, AD ;
KALLOK, MJ ;
BOURLAND, JD ;
TACKER, WA .
CIRCULATION, 1986, 73 (03) :484-491