A Critical Period of Ventricular Fibrillation More Susceptible to Defibrillation: Real-Time Waveform Analysis Using a Single ECG Lead.
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| Title: | A Critical Period of Ventricular Fibrillation More Susceptible to Defibrillation: Real-Time Waveform Analysis Using a Single ECG Lead. |
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| Authors: | Hsia, Peng-Wie E.1,2, Frerk, Sylvia1, Allen, Cynthia A.2, Wise, Robert M.2, Cohen, Neri M.2, Ralph J. Damiano, Jr.2 |
| Source: | Pacing & Clinical Electrophysiology. Apr1996, Vol. 19 Issue 4, p418-430. 13p. |
| Subjects: | Ventricular fibrillation, Electric countershock, Electrocardiography, High voltages, Cardiac pacing, Electrophysiology |
| Abstract: | Previous studies have suggested that variations in the underlying ventricular fibrillation (VF) waveform maybe one of the factors responsible for the probabilistic nature of defibrillation. The heart appeared to be more susceptible to defibrillation at higher absolute VF voltages (AVFV). This study investigated in an open-chest canine model (n = 8), a newly developed system that analyzed the VF waveform in real-time, instantaneously determined the time to shock, and immediately delivered a fixed low energy DC shock. A two parameter tracking technique using a running long-term and short-term AVFV average was devised to automatically identify a high voltage peak area of the VF waveform, which has been hypothesized to represent a critical period susceptible to defibrillation. Using a DC shock estimated at the 50% success level, the performance using this technique in 58 defibrillation trials was compared to the performance of the conventional method of shocking at a fixed time (random shock method) in 62 trials. Patch size, electrode location, and discharge voltage were kept constant while VF duration, transmyocardial resistance (TMR), energy delivered, and AVFV at the point of shock were measured. Shock energy and current, TMR, and VF duration were similar with both shock methods. A significantly higher AVFV was observed for trials performed with the peak shock method (0.66 ± 0.02 mV) as compared to trials performed with the random shock method (0.25 ± 0.09 mV) (P < 0.003). Using lead II as the only sensing lead, the success rate was increased in 6 of 8 dogs (75%) with the new method. One animal showed identical performance, and one animal a worse performance. The overall increase in success rate was 24% using a single ECG lead (range 0%-100%; P < 0.04). Our data document that using this algorithm a period of high VF voltage can be detected in realtime. The improved success in the majority of animals supports the hypothesis that a critical period susceptible to defibrillation exists during VF. However, the high AVFV detected using a single ECG lead did not translate to an improved success rate in all animals. This suggests that other factors in addition to the VF voltage measured on a single lead of the ECG are important in characterizing this critical period. [ABSTRACT FROM AUTHOR] |
| Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: egs DbLabel: Engineering Source An: 17510309 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: A Critical Period of Ventricular Fibrillation More Susceptible to Defibrillation: Real-Time Waveform Analysis Using a Single ECG Lead. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Hsia%2C+Peng-Wie+E%2E%22">Hsia, Peng-Wie E.</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Frerk%2C+Sylvia%22">Frerk, Sylvia</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Allen%2C+Cynthia+A%2E%22">Allen, Cynthia A.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Wise%2C+Robert+M%2E%22">Wise, Robert M.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Cohen%2C+Neri+M%2E%22">Cohen, Neri M.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Ralph+J%2E+Damiano%2C+Jr%2E%22">Ralph J. Damiano, Jr.</searchLink><relatesTo>2</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pacing+%26+Clinical+Electrophysiology%22">Pacing & Clinical Electrophysiology</searchLink>. Apr1996, Vol. 19 Issue 4, p418-430. 13p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Ventricular+fibrillation%22">Ventricular fibrillation</searchLink><br /><searchLink fieldCode="DE" term="%22Electric+countershock%22">Electric countershock</searchLink><br /><searchLink fieldCode="DE" term="%22Electrocardiography%22">Electrocardiography</searchLink><br /><searchLink fieldCode="DE" term="%22High+voltages%22">High voltages</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiac+pacing%22">Cardiac pacing</searchLink><br /><searchLink fieldCode="DE" term="%22Electrophysiology%22">Electrophysiology</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Previous studies have suggested that variations in the underlying ventricular fibrillation (VF) waveform maybe one of the factors responsible for the probabilistic nature of defibrillation. The heart appeared to be more susceptible to defibrillation at higher absolute VF voltages (AVFV). This study investigated in an open-chest canine model (n = 8), a newly developed system that analyzed the VF waveform in real-time, instantaneously determined the time to shock, and immediately delivered a fixed low energy DC shock. A two parameter tracking technique using a running long-term and short-term AVFV average was devised to automatically identify a high voltage peak area of the VF waveform, which has been hypothesized to represent a critical period susceptible to defibrillation. Using a DC shock estimated at the 50% success level, the performance using this technique in 58 defibrillation trials was compared to the performance of the conventional method of shocking at a fixed time (random shock method) in 62 trials. Patch size, electrode location, and discharge voltage were kept constant while VF duration, transmyocardial resistance (TMR), energy delivered, and AVFV at the point of shock were measured. Shock energy and current, TMR, and VF duration were similar with both shock methods. A significantly higher AVFV was observed for trials performed with the peak shock method (0.66 ± 0.02 mV) as compared to trials performed with the random shock method (0.25 ± 0.09 mV) (P < 0.003). Using lead II as the only sensing lead, the success rate was increased in 6 of 8 dogs (75%) with the new method. One animal showed identical performance, and one animal a worse performance. The overall increase in success rate was 24% using a single ECG lead (range 0%-100%; P < 0.04). Our data document that using this algorithm a period of high VF voltage can be detected in realtime. The improved success in the majority of animals supports the hypothesis that a critical period susceptible to defibrillation exists during VF. However, the high AVFV detected using a single ECG lead did not translate to an improved success rate in all animals. This suggests that other factors in addition to the VF voltage measured on a single lead of the ECG are important in characterizing this critical period. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1540-8159.1996.tb06512.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 418 Subjects: – SubjectFull: Ventricular fibrillation Type: general – SubjectFull: Electric countershock Type: general – SubjectFull: Electrocardiography Type: general – SubjectFull: High voltages Type: general – SubjectFull: Cardiac pacing Type: general – SubjectFull: Electrophysiology Type: general Titles: – TitleFull: A Critical Period of Ventricular Fibrillation More Susceptible to Defibrillation: Real-Time Waveform Analysis Using a Single ECG Lead. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Hsia, Peng-Wie E. – PersonEntity: Name: NameFull: Frerk, Sylvia – PersonEntity: Name: NameFull: Allen, Cynthia A. – PersonEntity: Name: NameFull: Wise, Robert M. – PersonEntity: Name: NameFull: Cohen, Neri M. – PersonEntity: Name: NameFull: Ralph J. Damiano, Jr. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr1996 Type: published Y: 1996 Identifiers: – Type: issn-print Value: 01478389 Numbering: – Type: volume Value: 19 – Type: issue Value: 4 Titles: – TitleFull: Pacing & Clinical Electrophysiology Type: main |
| ResultId | 1 |
