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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Detection of the defibrillation threshold using the upper limit of vulnerability following defibrillator implantation.
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Detection of the defibrillation threshold using the upper limit of vulnerability following defibrillator implantation.

机译：使用除颤器植入后的易损性上限检测除颤阈值。

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OBJECTIVE: This study was designed to test defibrillation threshold (DFT) with the least number of fibrillation inductions using upper limit of vulnerability (ULV) and to describe the most practical set of ICD during DFT following implantation. BACKGROUND: Although the correlation between ULV and DFT has been well described, there has been no uniform DFT testing protocol taking the advantage of ULV after defibrillator (ICD) implantation. METHODS: A total of 26 patients undergoing a new ICD implantation had a DFT induced with scanned T wave shock. The hypothesis that ventricular fibrillation (VF) could be defibrillated with 5 J higher than the highest T wave shock needed to induce VF or with 10 J if the T wave shock needed to induce VF was less than 5 J, was tested and 20 patients fulfilled these criteria. The methodology is improved by detecting peak T wave with 12-lead ECG, applying biphasic T wave shock and scanning the T wave shock in a wider window. RESULTS: Five patients in the first group (n = 15) and one patient in the second group (n = 11) did not fulfill the above hypothesis. The common features of six patients who did not fulfill the hypothesis were that T wave shock needed to induce VF was either under 5 J (5 patients) or high (1 patient). CONCLUSION: This study revealed the importance of methodology in studies regarding ULV and DFT. Following ICD implantation, we propose the first biphasic T wave detected by 12-lead ECG and rescue shock set at 10 and 15 J, respectively. If any of the scanned T wave (40 ms before and 40 ms after the peak T wave with decrements and increments of 20 ms) shocks could not induce VF, then the T wave and the first rescue shock should be set at 5 and 10 J, respectively. If the induction of VF has been unsuccessful with T wave shock at 5 J, then a safe defibrillation with 10 J should be expected in majority.
机译：目的：本研究旨在使用易损性上限（ULV）以最少的颤动感应测试除颤阈值（DFT），并描述植入后DFT期间最实用的ICD组。背景：尽管已经很好地描述了ULV和DFT之间的相关性，但是还没有统一的DFT测试协议可以利用除颤器（ICD）植入后的ULV优势。方法：总共26例接受新的ICD植入的患者因扫描T波休克​​而诱发了DFT。验证了以下假设：对心室纤颤（VF）进行除颤可以比诱发VF所需的最高T波电击高5 J，如果对诱发VF所需的T波电击小于5 J则可以对10 F进行除颤。这些标准。通过使用12导联心电图检测峰值T波，施加双相T波冲击并在更宽的窗口中扫描T波冲击来改进方法。结果：第一组中有5例患者（n = 15），第二组中有1例患者（n = 11）不符合上述假设。六名未实现该假设的患者的共同特征是诱导VF所需的T波电击在5 J以下（5例）或高（1例）。结论：本研究揭示了方法论在有关ULV和DFT的研究中的重要性。植入ICD后，我们建议通过12导联心电图和救援电击分别设置在10 J和15 J处检测到第一个双相T波。如果任何扫描的T波（在峰值T波之前40 ms之前和之后40 ms，以20 ms的减量和增量递增）不能引起VF，则应将T波和第一个急救电击设为5 J和10 J ， 分别。如果在5 J的T波电击下VF的诱导失败，那么多数情况下应该预期10 J的安全除颤。

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