Jul 15, 1997

High-energy defibrillation increases the severity of postresuscitation myocardial dysfunction

Circulation
J XieJoe Bisera

Abstract

The fatal outcome of victims after initially successful resuscitation from cardiac arrest has been attributed both to global myocardial ischemia during the interval of cardiac arrest and to the adverse effects of reperfusion. The present study was prompted by earlier experimental observation that the magnitude of myocardial dysfunction was in part related to the energy delivered during electrical defibrillation. Ventricular fibrillation (VF) was induced in 15 Sprague-Dawley rats. Precordial compression was begun together with mechanical ventilation after 4 minutes of untreated VF and continued for 6 minutes. Spontaneous circulation was restored in each animal after external defibrillation with a single stored 2-, 10-, or 20-J countershock. Cardiac index and the rate of left ventricular pressure rise at left ventricular pressure of 40 mm Hg (dP/dt40) and fall (negative dP/dt) during the 240-minute interval after successful resuscitation were decreased, and left ventricular diastolic pressure was increased. These decreases in myocardial function were closely related to the energy of electrical defibrillation. After a 20-J shock, animals survived for only 5+/-3 hours; after a 10-J shock, animals survived for 15+/-4 hours; and afte...Continue Reading

  • References20
  • Citations136

References

Mentioned in this Paper

Myocardial Contraction
Ventricular Fibrillation
Myocardial Dysfunction
Myocardium
Fatal Outcome
Basic Cardiac Life Support
Myocardial Ischemia
Left Ventricular Function
Adverse Effects
Coronary Arteriosclerosis

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