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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The effect of inducing ventricular fibrillation with 50-Hz pacing versus T wave stimulation on the ability to defibrillate.
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The effect of inducing ventricular fibrillation with 50-Hz pacing versus T wave stimulation on the ability to defibrillate.

机译：50 Hz起搏诱发的心室纤颤与T波刺激相比对除颤能力的影响。

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摘要

When testing an ICD, there are at least two techniques for inducing ventricular fibrillation: (1) high frequency (approximately equal to 50 Hz) pacing; and (2) a single T wave stimulus. It is generally assumed that these two methods yield similar results. This study directly tested this assumption. In six dogs, one defibrillation electrode was placed in the right ventricular (RV) apex and the second was placed cutaneously on the left thorax. All defibrillation and T wave stimuli were biphasic between these two electrodes. Pacing was monophasic from the tip of the RV catheter to the cutaneous patch. The voltage which defibrillates 50% of the time (DF50) was measured using a 10-step Bayesian up-down method. Observations for two DF50 measurements were randomly interleaved. For one DF50 measurement, fibrillation was induced with 99 pacing stimuli at a 20-ms pacing interval (50-Hz pacing). For the second DF50 measurement, fibrillation was induced with a single defibrillation shock of approximately 1/2 J delivered at a time corresponding to the peak of the T wave in the lead II electrogram (T wave stimuli). The average DF50 when measured after fibrillation induced with 50-Hz pacing was 379 +/- 54.6 V, as compared to 382 +/- 50.3 V when fibrillation was induced with T wave stimuli. The difference of 3 V was not statistically significant. If these results are confirmed in humans, it is reasonable to assume that the efficacy of a defibrillation shock is the same whether T wave stimuli or 50-Hz pacing are used to induce fibrillation.
机译：在测试ICD时，至少有两种诱发心室纤颤的技术：（1）高频（大约等于50 Hz）起搏; （2）单个T波刺激。通常假定这两种方法产生相似的结果。这项研究直接检验了这一假设。在六只狗中，将一个除颤电极放置在右心室（RV）的心尖中，将第二个除颤电极放置在皮肤上的左胸腔中。在这两个电极之间，所有的除颤和T波刺激都是双相的。从RV导管的尖端到皮肤贴片起搏是单相的。使用10步贝叶斯上下法测量50％时间的除颤电压（DF50）。两个DF50测量值的观察值是随机交错的。对于一次DF50测量，在20毫秒起搏间隔（50 Hz起搏）下用99个起搏刺激引起原纤维形成。对于第二次DF50测量，在与II型铅电描记图中的T波峰值（T波刺激）相对应的时间内，以大约1/2 J的单次除颤电击诱发了原纤维形成。在50 Hz起搏诱发的原纤维形成后，测得的平均DF50为379 +/- 54.6 V，而T波刺激诱发的原纤维形成时为382 +/- 50.3V。 3 V的差异无统计学意义。如果在人体中证实了这些结果，则可以合理地假设，无论使用T波刺激还是50 Hz起搏来诱发纤颤，除颤电击的功效都相同。

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