Resuscitation
Volume 81, Issue 4 , Pages 477-480 , April 2010

Transthoracic defibrillation potential gradients in a closed chest porcine model of prolonged spontaneous and electrically induced ventricular fibrillation

  • James T. Niemann

      Affiliations

    • The David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
    • Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA, United States
    • Corresponding Author InformationCorresponding author at: Harbor-UCLA Medical Center, Department of Emergency Medicine, 1000 West Carson Street, Box 21, Torrance, CA 90509, United States. Tel.: +1 310 222 3503; fax: +1 310 782 1763.
  • ,
  • John P. Rosborough

      Affiliations

    • Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA, United States
  • ,
  • Scott T. Youngquist

      Affiliations

    • The Department of Surgery, Division of Emergency Medicine, University of Utah, Salt Lake City, UT, United States
  • ,
  • Atman P. Shah

      Affiliations

    • The Department of Medicine, Division of Cardiology, University of Chicago, Chicago, IL, United States

Received 3 October 2009 ,Revised 8 December 2009 ,Accepted 23 December 2009.

References 

  1. American Heart Association Heart Disease and Stroke Statistics; 2009. Update at-a-glance. http://www.americanheart.org.
  2. Neumar RW, Nolan JP, Adrie C, et al. Post-cardiac arrest syndrome. Epidemiology, pathophysiology, treatment, and prognostication. Circulation. 2008;118:2452–2483
  3. Nichol G, Thomas E, Callaway CW, et al. Regional variation in out-of-hospital cardiac incidence and outcome. JAMA. 2008;300:1423–1431
  4. Mehta D, Curwin J, Gomes A, Fuster V. Sudden death in coronary artery disease. Acute ischemia versus myocardial substrate. Circulation. 1997;96:3215–3223
  5. Niemann JT, Rosborough UP, Youngquist S, Thomas J, Lewis RJ. Is all ventricular fibrillation the same? A comparison of ischemically induced with electrically induced ventricular fibrillation in a porcine cardiac arrest and resuscitation model. Crit Care Med. 2007;35:1356–1361
  6. Wang J, Weil MH, Tang W, Chang Y, Huang L. A comparison of electrically induced cardiac arrest with cardiac arrest produced by coronary occlusion. Resuscitation. 2007;72:477–483
  7. Ouyang P, Brinker JA, Bulkley BH, Jugdutt BI, Varghese PJ. Ischemic ventricular fibrillation: the importance of being spontaneous. Am J Cardiol. 1981;48:455–459
  8. Walcott GP, Killingsworth CR, Smith WM, Ideker RE. Biphasic waveform external defibrillation thresholds for spontaneous ventricular fibrillation secondary to acute ischemia. J Am Coll Cardiol. 2002;39:359–365
  9. Qin H, Walcott GP, Killingsworth CR, Rollins DL, Smith WM, Ideker RE. Impact of myocardial ischemia and reperfusion on ventricular fibrillation patterns, energy requirements, and detection of recovery. Circulation. 2002;105:2537–2542
  10. Niemann JT, Rosborough JP, Walker RG. A model of ischemically induced ventricular fibrillation for comparison of fixed-dose and escalating-dose defibrillation strategies. Acad Emerg Med. 2004;11:619–624
  11. Niemann JT, Walker RG, Rosborough JP. Intracardiac voltage gradients during transthoracic defibrillation: implications for postshock myocardial injury. Acad Emerg Med. 2005;12:99–105
  12. Rosborough JP, Deno C, Walker RG, Niemann JT. A percutaneous catheter-based system for the measurement of potential gradients applicable to the study of transthoracic defibrillation. PACE. 2007;30:166–174
  13. Gliner BR, Roger RD. Electrocardiographic evaluation of defibrillation shocks delivered to out-of-hospital sudden cardiac arrest patients. Resuscitation. 1999;41:133–144
  14. Walcott GP, Melnick SB, Chapman FW, Jones JL, Smith WM, Ideker RE. Relative efficacy of monophasic and biphasic waveforms for transthoracic defibrillation after short and long durations of ventricular fibrillation. Circulation. 1998;98:2210–2215
  15. Sims JJ, Miller AW, Ujhelyi MR. Regional hyperkalemia increases ventricular fibrillation energy requirements: role of electrical heterogeneity in defibrillation. J Cardiovasc Electrophysiol. 2000;11:634–641
  16. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Part 5: electrical therapies . Automated external defibrillators, defibrillation, cardioversion, and pacing. Circulation. 2005;112(Suppl. IV):IV-35–IV-46
  17. Chamberlain D, Frenneaux M, Steen S, Smith A. Why do chest compressions aid delayed defibrillation?. Resuscitation. 2008;77:10–15
  18. Chen P, Wolf PD, Claydon FJ, et al. The potential gradient created by epicardial defibrillation in dogs. Circulation. 1986;74:626–636
  19. Allred JD, Killingsworth CR, Allison S, et al. Transmural recording of shock potential gradient fields, early postshock activations, and refibrillation episodes associated with external defibrillation of long-duration ventricular fibrillation in swine. Heart Rhythm. 2008;5:1599–1606

 A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2009.12.027.

PII: S0300-9572(10)00014-6

doi: 10.1016/j.resuscitation.2009.12.027

Resuscitation
Volume 81, Issue 4 , Pages 477-480 , April 2010