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Study of DFT energy during ICD implant

ICD植入过程中DFT能量的研究

基本信息

批准号：
05671142
负责人：
TANAKA Shigeo
金额：
$ 0.45万
依托单位：
NIPPON MEDICAL SCHOOL
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1994
项目状态：
已结题

项目摘要

It is necessary to measure defibrillation threshold (DFT) during implantation of the implantable cardioverter defibrillator (ICD). Determination of DFT requires repeated induction of ventricular fibrillation and defibrillation attempts using high-enrergy shocks. These may lead to cerebral ischemia and myocardial damage. In recent studies, uppper limit of vulnerability (ULV) has been shown to closely correlate with DFT in aminal models.We examined whether ULV is present in human and whether ULV can be used to accurately predict DFT during implantation of ICD.We underwent the ICD implantation for life-threatening ventricular arrhythmia. During the implantation, the shock strength associated with a 50% probabirity of reaching ULV (ULV50) and a 50% probabirity of reaching DFT (DFT50) were determined by the delayd four-episode up down algorithm.ULV existed in each cases. ULV50 was 3.8 <plus-minus> 2.0J and DFT50 was 6.5 <plus-minus> 4.9J.The correlation between ULV50 and DFT50 is signific(r=0.99, P<0.0001, DFT50=-2.97*2.45ULV50)Conclution : Measurement of UVL can be used as a substitutes for measurement of DFT during implantation of ICD,and significantly reduce the number of. VF induction and shock required to determinarion of DFT.Therefore, we are thinking to analyze the mechanism of defibrillation using multi-channel mapping device.

在植入式心律转复除颤器（ICD）植入过程中需要测量除颤阈值（DFT）。 DFT 的测定需要使用高能电击反复诱导心室颤动和除颤尝试。这些都可能导致脑缺血和心肌损伤。最近的研究表明，脆弱性上限（ULV）与动物模型中的DFT密切相关。我们检查了ULV是否存在于人体中，以及ULV是否可以用于准确预测ICD植入期间的DFT。我们为危及生命的室性心律失常进行了ICD植入。在植入过程中，通过延迟四阶段上下算法确定与达到ULV（ULV50）的50％概率和达到DFT（DFT50）的50％概率相关的冲击强度。每种情况下都存在ULV。 ULV50为3.8<正负>2.0J，DFT50为6.5<正负>4.9J。ULV50与DFT50之间相关性显着(r=0.99，P<0.0001，DFT50=-2.97*2.45ULV50)结论：UVL测量可以替代DFT测量。植入ICD，并显着减少数量。确定DFT需要VF感应和电击。因此，我们正在考虑使用多通道标测设备来分析除颤机制。