COMPARISON OF THE DEFIBRILLATION THRESHOLD AND THE UPPER LIMIT OF VENTRICULAR VULNERABILITY
COMPARISON OF THE DEFIBRILLATION THRESHOLD AND THE UPPER LIMIT OF VENTRICULAR VULNERABILITY
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DOI：
10.1161/01.cir.73.5.1022
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发表时间：
1986-05-01
期刊：
影响因子：
37.8
通讯作者：
IDEKER, RE
中科院分区：
文献类型：
--
作者：
CHEN, PS;SHIBATA, N;IDEKER, RE
为了研究除颤阈值和电击强度之间的关系，我们在22只开胸犬中使用心外膜除颤电极（阴极在心室尖，阳极在右心房）测定了除颤阈值。我们还确定了是否有一个上限的电击强度，诱导纤颤在脆弱的时期，通过这些相同的电极在复极阶段的起搏节律给予各种能量的冲击。在8只犬中，阳极位于心室尖，阴极位于右心房，在另外8只犬中，阴极位于心室尖，阳极位于左心房，也进行了上述测定。在所有电极配置的所有犬中，在易损期诱导室颤的电击强度存在上限。根据电极组合，心室易损性的上限与除颤阈值无显著差异或略低于除颤阈值。对于所有三种电极配置，两者之间的相关系数非常显著。这些结果支持了以下假设：使用心外膜电极成功除颤需要达到或超过心室易损性上限的电击强度，并且略低于除颤阈值的电击失败，因为它们通过在其易损期刺激部分心肌而重新引发心室颤动。
To examine the relationship between the defibrillation threshold and the strength of shocks that induce ventricular fibrillation during the vulnerable period, we determined the defibrillation threshold in 22 open-chest dogs using epicardial defibrillation electrodes with the cathode at the ventricular apex and the anode at the right atrium. We also determined whether there was an upper limit of shock strength that induces fibrillation in the vulnerable period by giving shocks of various energy through these same electrodes during the repolarization phase of paced rhythm. The above determinations were also made with the anode at the ventricular apex and the cathode at the right atrium in eight of the dogs and with the cathode at the ventricular apex and the anode at the left atrium in another eight of the dogs. In all dogs for all electrode configurations, there was an upper limit to the shock strength that induced ventricular fibrillation during the vulnerable period. Depending on the electrode combination, this upper limit of ventricular vulnerability either was not significantly different from or was slightly lower than the defibrillation threshold. The correlation coefficient between the two was highly significant for all three electrode configurations. These results support the hypothesis that successful defibrillation with epicardial electrodes requires a shock strength that reaches or exceeds the upper limit of ventricular vulnerability and that shocks slightly lower than the defibrillation threshold fail because they reinitiate ventricular fibrillation by stimulating portions of the myocardium during their vulnerable period.