A low tilt waveform in the transthoracic defibrillation of ventricular arrhythmias during cardiac arrest

Resuscitation
Karen M DarraghA A Jennifer Adgey

Abstract

Most commercially available defibrillators utilise a high tilt waveform. Work in atrial fibrillation has shown improved defibrillation success using low tilt waveforms. We hypothesise that a novel low tilt biphasic waveform will be non-inferior to a standard tilt waveform whilst delivering lower energy for the defibrillation of ventricular arrhythmias. Patients in cardiac arrest who experienced ventricular arrhythmias received shocks from a novel low tilt waveform defibrillator at 120J or a standard tilt waveform defibrillator at 150J. Resuscitation guidelines were followed as per Resuscitation Council UK, 2005. A shock was successful when the ventricular arrhythmia was terminated for ≥ 5s following shock delivery. A total of 113 cardiac arrest cases were included. The low tilt device was used for 56 cases and the standard tilt device for 57 cases. The presenting rhythm was ventricular fibrillation (VF) in 71.7% (81/113), pulseless electrical activity (PEA) in 15.9% (18/113), ventricular tachycardia (VT) in 9.7% (11/113), asystole in 1.8% (2/113) and narrow complex rhythm in 0.9% (1/113). The low tilt device resulted in first shock success in 86% (48/56 cases) vs. the standard tilt device first shock success of 77% (44/57 cases...Continue Reading

References

Nov 1, 1990·Pacing and Clinical Electrophysiology : PACE·W Irnich
Jan 1, 1989·Journal of the American College of Cardiology·A S TangR E Ideker
Apr 1, 1995·Pacing and Clinical Electrophysiology : PACE·W Irnich
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Jun 1, 1997·Pacing and Clinical Electrophysiology : PACE·J SraM Akhtar
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Apr 6, 2004·Journal of the American College of Cardiology·Wanchun TangDavid Snyder
Sep 27, 2006·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Simon J WalshA A Jennifer Adgey

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