Internal atrial defibrillation in humans. Improved efficacy of biphasic waveforms and the importance of phase duration.
Internal atrial defibrillation in humans. Improved efficacy of biphasic waveforms and the importance of phase duration.
复制标题
人类体内心房除颤。
DOI：
10.1161/01.cir.95.6.1487
复制
发表时间：
1997
期刊：
影响因子：
37.8
通讯作者：
Wharton,JM
中科院分区：
文献类型：
--
作者：
Cooper,RA;Johnson,EE;Wharton,JM
人类内部心房除颤（IAD）的最佳波形尚不清楚。本研究测试了波形持续时间和相位持续时间对双相波形治疗IAD疗效的影响。方法与结果13例患者均在右心耳和冠状窦置入电极。第一部分比较6例患者5种单相波形（2、4、6、10、20 ms）和5种对称双相波形（1/1、2/2、3/3、5/5、10/10 ms）的心房除颤阈值（ADFTs）。第2部分比较了7例非对称双相波形（7.5/2.5 ms和2.5/7.5 ms）与对称双相波形（5/ 5ms）和单相波形（10 ms）的adft。在第一部分中，总持续时间为4 ~ 20 ms的双相波形的adft明显低于相同总持续时间的单相波形。在总持续时间为2 ms时，双相波形和单相波形的ADFTs无显著差异。4 ~ 20 ms的对称双相波形无明显差异。在第二部分中，7.5/2.5 ms非对称双相波形的adft明显低于其他三种波形。7.5/2.5 ms非对称双相和5/5 ms对称双相波形的adft均显著低于2.5/7.5 ms非对称双相和10 ms单相波形。结论双相波形比单相波形更有效。这种改善的疗效与双相波形的总持续时间和双相波形的每个单独的相位持续时间有关。
BackgroundThe optimal waveform for internal atrial defibrillation (IAD) in humans is unknown. This study tested the effect of waveform duration and phase duration on the efficacy of biphasic waveforms for IAD.Methods and ResultsElectrodes were positioned in the right atrial appendage and coronary sinus in 13 patients. In part 1, the atrial defibrillation thresholds (ADFTs) for 5 monophasic waveforms (2, 4, 6, 10, and 20 ms) and 5 symmetrical biphasic waveforms (1/1, 2/2, 3/3, 5/5, and 10/10 ms) were compared in 6 patients. In part 2, the ADFTs for two asymmetrical biphasic waveforms (7.5/2.5 and 2.5/7.5 ms) were compared with those for a symmetrical biphasic waveform (5/5 ms) and a monophasic waveform (10 ms) in 7 patients. In part 1, biphasics with total durations of 4 to 20 ms had significantly lower ADFTs than monophasic waveforms of the same total duration. For a total duration of 2 ms, there was no significant difference in ADFTs between the biphasic and the monophasic waveforms. There was no difference between symmetrical biphasic waveforms of 4 to 20 ms. In part 2, the 7.5/2.5 ms asymmetrical biphasic had significantly lower ADFTs than the three other waveforms tested. Both the 7.5/2.5 ms asymmetrical and the 5/5 ms symmetrical biphasic waveform had significantly lower ADFTs than the 2.5/7.5 ms asymmetrical biphasic and the 10 ms monophasic waveforms.ConclusionsFor IAD in humans, biphasic waveforms were more efficacious than monophasic waveforms. This improved efficacy is related to the total duration of the biphasic waveform and each individual phase duration of the biphasic waveform.