Jan 22, 2002

Optimizing timing of ventricular defibrillation

Critical Care Medicine
A Marn-PernatJ Bisera

Abstract

Our intent was to evolve a prognosticator that would predict the likelihood that an electrical shock would restore a perfusing rhythm. Such a prognosticator was to be based on conventional electrocardiographic signals but without constraints caused by artifacts resulting from precordial compression. The adverse effects of "hands off" intervals for rhythm analyses would therefore be minimized. Such a prognosticator was further intended to reduce the number of electrical shocks and the total energy delivered and thereby minimize postresuscitation myocardial dysfunction. Observational study. Medical research laboratory of a university-affiliated research and educational institute. Domestic pigs. Ventricular fibrillation was induced in an established porcine model of cardiac arrest. Recordings of scalar lead 2 over the frequency range of 4-48 Hz were utilized. The area under the curve representing the amplitude and frequency was defined as the amplitude spectrum area (AMSA). A derivation group of 55 animals yielded a threshold value of AMSA that uniformly predicted successful resuscitation. A separate group of 10 animals, a validation group, confirmed that an AMSA value of 21 mV.Hz predicted restoration of perfusing rhythm after 7 ...Continue Reading

Mentioned in this Paper

Area Under Curve
Ventricular Fibrillation
Amsacrine
Myocardial Dysfunction
Myocardium
Shock
Dicom Derivation
Adverse Effects
Etiology
Cardiomyopathies

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