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首页> 外文期刊>Prehospital emergency care >Efficacy of lower-energy biphasic shocks for transthoracic defibrillation:: A follow-up clinical study.
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Efficacy of lower-energy biphasic shocks for transthoracic defibrillation:: A follow-up clinical study.

机译：低能量双相电击治疗经胸除颤的疗效：一项后续临床研究。

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OBJECTIVE: This clinical study prospectively evaluated the first-shock defibrillation efficacy of 150-joule impedance-compensated, 200-microF biphasic truncated exponential (BTE) shocks in patients with electrically-induced ventricular fibrillation (VF), and compared it with a historical control group treated with 200-J monophasic damped sine (MDS) shocks. METHODS: Ventricular tachyarrhythmias were induced in patients undergoing electrophysiologic (EP) testing for ventricular arrhythmias or testing of an implantable cardioverter-defibrillator (ICD). A 150-J shock was delivered as the primary therapy to terminate induced arrhythmias in the EP group, and as a "rescue" shock when a single ICD shock failed to terminate the arrhythmias in the ICD group. RESULTS: Ninety-six patients received study shocks. The preshock rhythm was classified as VF in 77 patients and as ventricular tachycardia (VT) in 19 patients. First-shock success rates for VF and VT were 75 out of 77 (97.4%) and 19 out of 19 (100%) for the 150-J BTE compared with the historical control rates of 61 out of 68 (89.7%) and 29 out of 31 (94%) for 200-J MDS. The first-shock success rate for VF treated with 150-J BTE was technically equivalent to that of 200-J MDS (p=0.001). The transthoracic impedance did not vary between groups, yet the peak current delivered by the 150-J BTE shock was about 50% lower. CONCLUSIONS: This study demonstrated that 150-J shocks of this impedance-compensated, 200-microF BTE waveform provided very high efficacy for defibrillation of short duration, electrically-induced VF. These lower-energy biphasic shocks had a success rate equivalent to that of 200-J MDS shocks, and they provided this efficacy while exposing patients to much less current than the monophasic shocks.
机译：目的：该临床研究前瞻性评估了150焦耳阻抗补偿，200 µF双相截断指数（BTE）电击对电诱发性心室纤颤（VF）患者的首次电击除颤疗效，并将其与历史对照进行了比较本组接受200-J单相阻尼正弦（MDS）电击治疗。方法：进行电生理检查（EP）的室性心律不齐或植入式心脏复律除颤器（ICD）的患者诱发室速性心律失常。 150 J电击作为终止EP组诱发的心律不齐的主要疗法，而当单次ICD电击未能终止ICD组的心律失常时作为“挽救”电击。结果：96例患者接受研究冲击。休克前节律在77例患者中被分类为VF，在19例患者中被分类为室性心动过速（VT）。对于150-J BTE，VF和VT的首次电击成功率分别为77分（75％）（97.4％）和19分（19％）（100％），而历史控制率分别为68分（89.7％）和61分的61 200 J MDS中有31个（94％）。用150 J BTE治疗的VF的首次电击成功率在技术上等于200 J MDS的电击成功率（p = 0.001）。两组之间的胸腔阻抗没有变化，但是150-J BTE电击所传递的峰值电流降低了约50％。结论：这项研究表明，这种阻抗补偿的200 µF BTE波形的150 J冲击对短时间电诱发的VF除颤具有非常高的功效。这些低能量双相电击的成功率与200-J MDS电击相当，它们在提供这种功效的同时，使患者承受的电流要比单相电击小得多。

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