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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing.
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Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing.

机译：内部心房除颤的波形优化：波形舍入，相位持续时间和电压摆幅的影响。

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摘要

The aim of this study was to compare the efficacy of internal atrial defibrillation by conventional truncated exponential biphasic waveforms with and without waveform rounding (1-2 phases) and to determine optimal duration for this novel double rounded waveform. Atrial fibrillation, induced by rapid electrical stimulation, was converted by internal shocks through defibrillation catheters (lateral right atrium and coronary sinus) in anesthetised sheep. Rounding the leading edges of the conventional biphasic waveform (Ventritex HVS-02; settings 100/-50 V, 150/-70 V, and 200/-100 V; n = 8) reduced delivered peak and trough voltages, currents, and energy (by > or = 21 %, P < 0.001; for double (both phases) rounded) without decreasing cardioversion success. At 100/-50 V the efficacy of single (first phase) rounded (53 +/- 13%; mean +/- SEM) and double rounded (59 +/- 11%) shocks was similar to the conventional waveform (56 +/- 14%). Double rounded waveform (phase durations 1-20 ms) efficacy was optimum at 6-10 ms phase duration (100% success at 10-ms phase duration; 1.52 +/- 0.04 J delivered energy; n = 6). Successful cardioversion by conventional, single rounded, and double rounded biphasic waveforms (duration 6 ms each phase), conventional monophasic, rounded monophasic (duration 12 ms), and a damped sine waveform correlated strongly with peak-to-trough voltage swing within the waveform (r = 0.882; P < 0.01; n = 8). For internal atrial defibrillation, rounding both phases of the conventional biphasic waveforms, the double rounded waveform, permits similar efficacy to the conventional truncated exponential biphasic waveform at reduced peak voltage, current, and delivered energy. Optimum phase duration is 6-10 ms (tested range 1-20 ms).
机译：这项研究的目的是比较传统的截断指数双相波形在有无波形舍入（1-2个相位）时的内部房颤除颤效果，并确定这种新型双舍入波形的最佳持续时间。快速电刺激引起的心房纤颤通过除颤导管（外侧右心房和冠状窦）的内部电击转换成麻醉的绵羊。舍入常规双相波形的前沿（Ventritex HVS-02;设置为100 / -50 V，150 / -70 V和200 / -100 V; n = 8）可减小传递的峰和谷电压，电流和能量（按>或= 21％，P <0.001;对于双（两个阶段）都是四舍五入的），而不会降低心脏复律的成功率。在100 / -50 V时，单（第一相）四舍五入（53 +/- 13％;平均值+/- SEM）和双四舍五入（59 +/- 11％）的功效类似于常规波形（56 + /-14％）。在6-10 ms的相位持续时间（10 ms的相位持续时间100％成功; 1.52 +/- 0.04 J的输送能量; n = 6）时，双舍入波形（相位持续时间1-20 ms）的效果最佳。常规，单次和双次双相波形（每个阶段的持续时间为6 ms），常规单相，舍入单相（持续时间为12 ms）和阻尼正弦波形可成功进行心脏复律，该正弦波形与该波形中的峰谷电压摆幅强烈相关（r ＝ 0.882; P ＜0.01; n ＝ 8）。对于内部心房除颤，在降低峰值电压，电流和传递能量的情况下，对常规双相波形的两个相位均进行四舍五入（双舍入波形）可实现与常规截断指数双相波形相似的功效。最佳相位持续时间为6-10毫秒（测试范围1-20毫秒）。

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