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首页> 外文期刊>Resuscitation. >A randomized controlled trial of efficacy and ST change following use of the Welch-Allyn MRL PIC biphasic waveform versus damped sine monophasic waveform for external DC cardioversion.
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A randomized controlled trial of efficacy and ST change following use of the Welch-Allyn MRL PIC biphasic waveform versus damped sine monophasic waveform for external DC cardioversion.

机译：使用Welch-Allyn MRL PIC双相波形与阻尼正弦单相波形进行外部直流电复律后，进行疗效和ST改变的随机对照试验。

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OBJECTIVE: Biphasic waveforms have similar or greater efficacy at cardioverting atrial and ventricular arrhythmias at lower energy levels than monophasic waveforms, and cause less ST depression following defibrillation of ventricular fibrillation. No studies have investigated this effect on ST change with atrial arrhythmias. We studied the efficacy of the Welch Allyn-MRL PIC biphasic defibrillator. METHODS: One hundred and thirty-nine patients undergoing elective DC cardioversion for atrial arrhythmias were randomised to cardioversion by monophasic (Hewlett Packard Codemaster XL; 100, 200, 300, 360 and 360J) or biphasic (Welch Allyn-MRL PIC; 70, 100, 150, 200 and 300J) defibrillator. We analysed success of cardioversion after 0 and 30min, cumulative energy, number of shocks and energy at successful cardioversion. The ST change in the recorded electrocardiogram was measured at 15s after all shocks using electronic callipers. RESULTS: Immediately after cardioversion 59/68 (86.8%) of the monophasic group versus 56/60 (93.3%) of the biphasic group were in sinus rhythm. Of the monophasic group, 55/67 (82.1%) remained in sinus rhythm at 30min versus 53/58 (91.4%) of the biphasic group. These differences were not significant at 0min (P=0.35) or 30min (P=0.21). The biphasic group required significantly fewer shocks (P=0.006), less cumulative energy (P<0.0001) and required lower total energy for successful cardioversion (P<0.0001). Of the 102 patients with electrocardiogram recordings suitable for analysis, ST segment change was greater in the monophasic group (P=0.037). CONCLUSIONS: The Welch Allyn-MRL biphasic waveform for DC cardioversion results in fewer shocks, with less cumulative energy delivered and less post shock ST change than with a Hewlett Packard Codemaster XL damped sine wave monophasic waveform.
机译：目的：双相波形在较低水平的能量水平下对心律失常的房性和室性心律失常具有相似或更高的功效，并且在使心室纤颤除颤后引起的ST压低较少。尚无研究调查这种对房性心律失常ST改变的影响。我们研究了Welch Allyn-MRL PIC双相除颤器的功效。方法：139例因房性心律失常而接受选择性DC心脏复律的患者被随机分为单相（Hewlett Packard Codemaster XL; 100、200、300、360和360J）或双相（Welch Allyn-MRL PIC; 70、100） ，150、200和300J）的除颤器。我们分析了0和30分钟后的复律成功，累积能量，电击次数和成功复律时的能量。在所有电击后15秒钟，使用电子游标卡尺测量记录的心电图中的ST变化。结果：心脏复律后，单相组59/68（86.8％）相对于双相组56/60（93.3％）呈窦性心律。在单相组中，在第30分钟时窦性心律仍为55/67（82.1％），而在双相组中为53/58（91.4％）。这些差异在0min（P = 0.35）或30min（P = 0.21）时不显着。双相组所需的电击次数显着减少（P = 0.006），累积的能量较少（P <0.0001），成功的心脏复律所需的总能量也较低（P <0.0001）。在102例适合分析的心电图记录患者中，单相组ST段变化更大（P = 0.037）。结论：与Hewlett Packard Codemaster XL阻尼正弦波单相波形相比，用于直流电复律的Welch Allyn-MRL双相波形可产生更少的电击，更少的累积能量传递和更少的电击后ST变化。

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