PMID: 8946452Nov 1, 1996Paper

The influence of sodium channel blockade on the defibrillation energy requirements of biphasic versus monophasic shocks

Pacing and Clinical Electrophysiology : PACE
S D NelsonA Saffarin

Abstract

The sodium channel-blocking actions of some Class I antiarrhythmic agents can increase the defibrillation energy requirements (DER) of monophasic shock waveforms. The influence of sodium channel blockade on biphasic shocks is less certain. The purpose of this study was to compare, in a randomized, placebo controlled study, the influence of lidocaine on the DER of biphasic and monophasic shock waveforms in a canine model of transvenous internal defibrillation. The DER was determined by the iterative increment-decrement protocol. Monophasic and biphasic shock DERs were tested at baseline and during lidocaine infusion (group A) or saline control (group B). Group A biphasic shock DERs increased significantly from a baseline of 12.1 +/- 3.6 J to 19.1 +/- 9.3 J when compared to group B (P = 0.005). In group A, the mean DER during lidocaine was significantly higher with monophasic shocks than biphasic shocks (29.6 +/- 11.8 J vs 19.1 +/- 9.3 J, respectively; P < 0.003), but the magnitude of change in biphasic versus monophasic shock DERs was not significantly different (F = 1.78; p = 0.193). There was a linear relationship between the baseline DER and the DER during lidocaine (r2 = 0.63, P < 0.0001). Sodium channel blockade with lidoca...Continue Reading

Citations

Oct 30, 1998·Pacing and Clinical Electrophysiology : PACE·Y MurakawaM Omata
Feb 6, 2004·Journal of Cardiovascular Electrophysiology·Li LiIgor R Efimov
Apr 29, 1998·Journal of Cardiovascular Electrophysiology·A P Winecoff MillerM R Ujhelyi
Jan 18, 2018·Expert Review of Cardiovascular Therapy·Federico GuerraAlessandro Capucci

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