Effect of direct-current countershocks on regional myocardial contractility and perfusion. Experimental studies

Circulation
R E KerberJ Grayzel

Abstract

Very high energy electrical countershocks can cause morphologic damage to the myocardium. In this study we searched for functional correlates of these shock-induced morphologic changes. We used ultrasonic sonomicrometers to measure myocardial contractility and radiolabeled microspheres to assess perfusion. Acute and chronic experiments were conducted in 45 dogs, assessing the effect of both direct (epicardial) and transthoracic shocks on beating and fibrillating hearts. High-energy or rapidly repeated epicardial shocks caused subepicardial contraction abnormalities. This indicates that electrical current delivered to the myocardium in sufficiently high amounts and concentration can cause functional damage. Thus, in open-chest defibrillation during cardiac surgery, low energies (10-20 J) should be used initially and higher energies resorted to only if lower-energy shocks fail. However, single and multiple transthoracic shocks up to 460 J delivered energy caused no detectable contraction abnormalities. Myocardial perfusion did not fall after shocks. Thus, high-energy transthoracic shocks may have no deleterious effects on the contraction and perfusion of normal myocardium.

References

Jun 1, 1978·The New England Journal of Medicine·B LownJ Gascho
Nov 1, 1978·British Heart Journal·A A Adgey
Feb 1, 1979·The American Journal of Cardiology·P W DohertyD C Harrison
Jan 1, 1976·The American Journal of Cardiology·A EhsaniB E Sobel
Jan 1, 1974·The Journal of Clinical Investigation·L A GeddesP S Cabler
Feb 1, 1970·The Journal of Clinical Investigation·D G Pansegrau, F M Abboud
Sep 1, 1980·The American Journal of Cardiology·R E KerberJ Kennedy

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Citations

Jun 1, 1993·The Annals of Thoracic Surgery·A BarakaA Sibaii
Aug 1, 1991·Journal of the American College of Cardiology·S KobayashiE Corday
Jan 1, 1994·Journal of Electrocardiology·A BaykalN V Thakor
Jun 28, 2003·The Journal of Thoracic and Cardiovascular Surgery·David G RabkinHenry M Spotnitz
Sep 3, 2002·Resuscitation·Hitoshi YamaguchiJoe Bisera
Nov 15, 1996·Journal of the American College of Cardiology·M R CaterineR E Kerber
Sep 14, 1999·Journal of the American College of Cardiology·W TangJ Bisera
Sep 2, 1999·Critical Care Medicine·R J GazmuriH Cajigas
Jan 22, 2002·Critical Care Medicine·A Marn-PernatJ Bisera
Nov 1, 2008·Critical Care Medicine·Giuseppe RistagnoMax Harry Weil
Oct 22, 2008·Critical Care Medicine·Min-Shan TsaiMax Harry Weil
Nov 1, 1992·Pacing and Clinical Electrophysiology : PACE·S D LucyG J Klein
Apr 4, 2013·Cardiology·John Somberg, Janos Molnar
Feb 8, 2013·Critical Care : the Official Journal of the Critical Care Forum·Kyoung-Ha ParkWoo Jung Park
May 1, 1990·Chest·R M ScheinC L Sprung
Jun 1, 2012·Cardiac Electrophysiology Clinics·Marshall W Winner, John D Hummel
Mar 1, 1985·The American Journal of Emergency Medicine·C L LakeR S Crampton
Jun 1, 1988·Journal of Cardiothoracic Anesthesia·M S MaxwellD M Gaba
Jan 1, 1991·The Journal of Surgical Research·M C StirlingK P Gallagher
Feb 5, 2004·The American Journal of Cardiology·Debashis RoyJuan Carlos Kaski
Aug 1, 1997·Annals of Emergency Medicine·R K ReddyG H Bardy
Aug 13, 2005·Resuscitation·Kenneth M SteinBruce B Lerman
Feb 1, 1982·The American Journal of Cardiology·G FontaineY Grosgogeat
Oct 8, 2003·The Annals of Thoracic Surgery·David G RabkinHenry M Spotnitz
Oct 29, 2000·Journal of Cardiothoracic and Vascular Anesthesia·A BarakaM Nawfal
Sep 4, 1998·Journal of Cardiovascular Electrophysiology·T TokanoS A Strickberger

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