Defibrillation Threshold Varies During Different Stages of Ventricular Fibrillation in Canine Hearts - 09/02/13

Doi : 10.1016/j.hlc.2012.08.059

Qi Jin, MD ^a,^{^{1
The first two authors contributed equally to this work.}}, Jian Zhou, MD ^a,^{^{1
The first two authors contributed equally to this work.}}, Ning Zhang, MD ^a, Changjian Lin, MD ^a, Yang Pang, MD ^a, Yangxun Xin, MD ^a, Jiajun Pan, MD ^b, Gang Gu, MD ^a, Weifeng Shen, MD, PhD ^a,^⁎ , Liqun Wu, MD, PhD ^a,^⁎
^a Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, PR China
^b Department of Cardiology, Shanghai Luwan Hospital, Shanghai, PR China

Corresponding authors at: Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, No. 197, Shanghai Ruijin Er Road, Shanghai 200025, PR China. Tel.: +86 021 64310871; fax: +86 021 64310871.

Résumé

Background

Recent studies have shown that short duration ventricular fibrillation (SDVF) and long duration ventricular fibrillation (LDVF) are maintained by different mechanisms. The objective of this study is to evaluate how the defibrillation threshold (DFT) varies over the duration of fibrillation since the mechanism of VF maintenance changes as VF progresses.

Methods

Twelve canines were randomly divided into two groups (Group A and B, n=6 each). DFTs were measured three times in each group: SDVF (20s), LDVF (3min in Group A and 7min in Group B) and the first episode of refibrillation after successful defibrillation for LDVF. Two 64-electrode baskets used to globally map the endocardium were deployed into the left ventricle and right ventricle, respectively.

Results

LDVF-DFT in Group A was significantly higher than that of Group B (628±98V vs 313±81V, P<0.001). In Group B, the DFT of refibrillation was significantly increased compared with the LDVF-DFT (570±199V vs 313±81V, P=0.035) but did not differ from the DFT of refibrillation in Group A (570±199V vs 638±116V, P=0.39). Highly synchronised activation patterns on the left ventricular endocardium were observed between 3 and 7min of LDVF in Group B but not within 3min-LDVF in Group A or during refibrillation in each group.

Conclusions

DFT varied during different stages of VF. The highly synchronised activation patterns exhibiting after 3min VF might contribute to the decreased LDVF-DFT.

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Keywords : Ventricular fibrillation, Defibrillation, Electrophysiology, Resuscitation

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Vol 22 - N° 2

P. 133-140 - février 2013 Retour au numéro

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Defibrillation Threshold Varies During Different Stages of Ventricular Fibrillation in Canine Hearts - 09/02/13

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