Upper limit of vulnerability is a good estimator of shock strength associated with 90% probability of successful defibrillation in humans with transvenous implantable cardioverter-defibrillators

Journal of the American College of Cardiology
Charles D SwerdlowP S Chen

Abstract

The goals of this study were to determine the probability of successful defibrillation at the upper limit of vulnerability and to evaluate a minimal safety margin for implantable cardioverter-defibrillator first shocks based solely on the upper limit of vulnerability. The upper limit of vulnerability is the strength at or above which ventricular fibrillation is not induced when a stimulus is delivered during the vulnerable phase of the cardiac cycle. It has been proposed as an estimate of defibrillation efficacy because it correlates with the defibrillation threshold and can be determined with a single episode of fibrillation. We studied 40 patients prospectively at implantation of transvenous cardioverter-defibrillators. Defibrillation threshold was defined as the weakest biphasic shock that defibrillated after 10 s of ventricular fibrillation. The upper limit of vulnerability was defined as the weakest biphasic shock that did not induce ventricular fibrillation when given at 0, 20 and 40 ms before the peak of the T wave in ventricular paced rhythm at cycle length 500 ms. After determination of the upper limit of vulnerability and defibrillation threshold, patients underwent six additional fibrillation-defibrillation episodes....Continue Reading

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Apr 11, 2014·Ulrika Birgersdotter-GreenUlrika Birgersdotter-Green

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Citations

Feb 6, 1999·Journal of the American College of Cardiology·S WindeckerA E Epstein
May 15, 1998·Journal of Cardiovascular Electrophysiology·C D SwerdlowP S Chen
Jun 2, 1998·Journal of Cardiovascular Electrophysiology·S M Dillon, K F Kwaku
Jun 2, 1998·Journal of Cardiovascular Electrophysiology·P S ChenH S Karagueuzian
Aug 1, 1997·Journal of Cardiovascular Electrophysiology·R A MalkinR E Ideker
Feb 1, 1997·Journal of Cardiovascular Electrophysiology·C D SwerdlowP S Chen
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Apr 1, 2008·Progress in Biophysics and Molecular Biology·Weihui LiNatalia A Trayanova
Aug 22, 2003·Journal of Cardiovascular Electrophysiology·Osnat T GurevitzCharles D Swerdlow
Mar 7, 2007·Pacing and Clinical Electrophysiology : PACE·Charles D SwerdlowPeng-Sheng Chen
May 30, 2008·Pacing and Clinical Electrophysiology : PACE·Michael ShehataCharles D Swerdlow
Aug 22, 2012·Pacing and Clinical Electrophysiology : PACE·Shephal K DoshiJesus E Val-Mejias
Apr 28, 2007·Pacing and Clinical Electrophysiology : PACE·Charles D SwerdlowPaul J Degroot
Sep 17, 2013·Pacing and Clinical Electrophysiology : PACE·Mehul B PatelRanjan K Thakur
Jul 6, 2004·Journal of the American College of Cardiology·S Adam Strickberger, George J Klein
Mar 29, 2016·Pacing and Clinical Electrophysiology : PACE·Michael PittaroMark W Kroll
Oct 12, 2012·Circulation. Arrhythmia and Electrophysiology·Ulrika Birgersdotter-GreenPaul A Friedman
Jan 16, 2002·Journal of Cardiovascular Pharmacology·Xiangqian QiPaul Dorian

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