Improved internal defibrillation efficacy with a biphasic waveform.

Abstract:

:Clinically available automatic implantable defibrillators use a monophasic truncated exponential waveform shock; after delivery the charge remaining on the device's capacitors is "dumped" internally and wasted. The efficacy of a monophasic and biphasic truncated exponential defibrillation waveform produced by a single capacitor discharge was compared in seven closed-chest, pentobarbital-anesthetized dogs. Defibrillation leads consisted of a new deployable intrapericardial electrode system. The monophasic waveform was positive and 6 msec in duration. The biphasic waveform had a positive phase identical to that of the monophasic waveform and a negative phase of equal duration with its initial voltage equal to 50% of the final voltage of the positive phase. Defibrillation shocks of varying initial voltage were delivered to construct curves of the percentage of successful defibrillation versus initial voltage and delivered energy, and the voltage and energy required for 50% (V50 and E50, respectively) and 80% (V80 and E80, respectively) success were compared. The biphasic waveform had significantly lower initial voltage (V50: 194 +/- 48 volts vs 227 +/- 48 volts, p less than 0.001; V80: 217 +/- 55 volts vs 256 +/- 66 volts, p less than 0.02) and energy (E50: 2.7 +/- 1.3 joules vs 3.4 +/- 1.5 joules, p less than 0.01; E80: 3.4 +/- 1.6 joules vs 4.3 +/- 2.2 joules, p less than 0.05) requirements than the monophasic waveform. It is concluded that a biphasic waveform produced by a single discharge that uses the "free" energy remaining on the capacitors significantly reduces the initial voltage and energy requirements for successful defibrillation and may improve the efficacy of future automatic implantable defibrillators.

journal_name

Am Heart J

journal_title

American heart journal

authors

Fain ES,Sweeney MB,Franz MR

doi

10.1016/0002-8703(89)90779-5

subject

Has Abstract

pub_date

1989-02-01 00:00:00

pages

358-64

issue

2

eissn

0002-8703

issn

1097-6744

pii

0002-8703(89)90779-5

journal_volume

117

pub_type

杂志文章
  • Circadian patterns of myocardial ischemia.

    abstract::In this overview we studied evidence for the occurrence of silent myocardial ischemia, its pathophysiologic mechanisms, and the circadian distribution of ischemic episodes. The correlation between many hemodynamic parameters and their potential as drug targets was assessed. ECG evidence of myocardial ischemia (ST segm...

    journal_title:American heart journal

    pub_type: 杂志文章,评审

    doi:10.1016/0002-8703(89)90830-2

    authors: Fox K,Mulcahy D,Keegan J,Wright C

    更新日期:1989-11-01 00:00:00

  • Toll-like receptor 4 gene Asp299Gly polymorphism is associated with reductions in vascular inflammation, angiographic coronary artery disease, and clinical diabetes.

    abstract:BACKGROUND:Coronary artery disease (CAD) and, increasingly, diabetes are recognized as having an inflammatory basis. Membrane toll-like receptors (TLRs) activate signaling pathways that up-regulate inflammation. We evaluated whether the Asp299Gly polymorphism in the TLR4 gene, which impairs inflammatory responses, is a...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2004.05.049

    authors: Kolek MJ,Carlquist JF,Muhlestein JB,Whiting BM,Horne BD,Bair TL,Anderson JL

    更新日期:2004-12-01 00:00:00

  • Effectiveness of a thermal shape-memory patent ductus arteriosus occlusion coil.

    abstract::A new shape-memory coil for transcatheter closure of the PDA was developed and evaluated in a dog PDA model. The coil is sensitive to temperature (composed of thermal shape-memory nickel-titanium). The coil was delivered to and implanted in the PDA model with a 5F catheter through the femoral artery. The PDA model was...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/s0002-8703(96)90189-1

    authors: Liu C,Shiraishi H,Kikuchi Y,Yanagisawa M

    更新日期:1996-05-01 00:00:00

  • Predicting significant coronary artery disease in patients with left ventricular dysfunction.

    abstract:BACKGROUND:Because coronary artery disease (CAD) is a prevalent comorbidity in patients with low ejection function (EF), a number of patients with heart failure undergo diagnostic cardiac catheterization. The objective of this study was to develop a model to assist clinicians in determining the likelihood of CAD before...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2005.12.001

    authors: Whellan DJ,Tuttle RH,Velazquez EJ,Shaw LK,Jollis JG,Ellis W,O'Connor CM,Califf RM,Borges-Neto S

    更新日期:2006-08-01 00:00:00

  • Cognitive decline and ischemic microlesions after coronary catheterization. A comparison to coronary artery bypass grafting.

    abstract:BACKGROUND:Postinterventional cognitive dysfunction (PICD) is a known complication of coronary artery bypass grafting (CABG). However, it is largely unknown whether PICD occurs after coronary catheterization. METHODS:Neuropsychologic data were obtained from 37 patients who received coronary catheterization and 47 pati...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2011.07.021

    authors: Schwarz N,Schoenburg M,Möllmann H,Kastaun S,Kaps M,Bachmann G,Sammer G,Hamm C,Walther T,Gerriets T

    更新日期:2011-10-01 00:00:00

  • Gender differences in dehydration-induced mitral valve prolapse.

    abstract::Mitral valve prolapse (MVP) is a common cardiac valve abnormality that affects women more frequently than men. We have previously shown that mild dehydration induces echocardiographic signs of MVP in approximately 50% of healthy asthenic women with previously normal cardiac findings. The present study was designed to ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(95)90047-0

    authors: Aufderheide S,Lax D,Goldberg SJ

    更新日期:1995-01-01 00:00:00

  • Danish multicenter randomized study on fibrinolytic therapy versus acute coronary angioplasty in acute myocardial infarction: rationale and design of the DANish trial in Acute Myocardial Infarction-2 (DANAMI-2).

    abstract:BACKGROUND:Randomized trials have indicated that primary coronary angioplasty performed in patients admitted directly to highly-experienced angioplasty centers offers certain advantages over intravenous fibrinolytic therapy. However, the large majority of patients with acute myocardial infarction are submitted to hospi...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/S0002-8703(03)00316-8

    authors: Andersen HR,Nielsen TT,Vesterlund T,Grande P,Abildgaard U,Thayssen P,Pedersen F,Mortensen LS,DANAMI-2 Investigators.

    更新日期:2003-08-01 00:00:00

  • Risk factors for acute and subacute stent thrombosis after high-pressure stent implantation: a study by intracoronary ultrasound.

    abstract:BACKGROUND:In the era of coronary stenting with high-pressure expansion, stent thrombosis remains a major life-threatening risk. Because of its superior imaging mode, intracoronary ultrasound could provide insight into potential risk factors for stent thrombosis. PATIENTS AND METHODS:In 215 patients with stent implant...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/s0002-8703(98)70097-3

    authors: Werner GS,Gastmann O,Ferrari M,Schuenemann S,Knies A,Diedrich J,Kreuzer H

    更新日期:1998-02-01 00:00:00

  • Atrial coronary hyperemia and ischemia in response to variations in atrial pressure in dogs.

    abstract::We altered the mechanical activity of the atrial myocardium in open-chest dogs and measured changes in coronary blood flow distribution, using the radioactive microsphere technique. When left and right atrial pressures were decreased to 2 mm Hg by hypovolemia, atrial coronary blood flow fell to values nearly 50% below...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(83)90701-9

    authors: Neill WA,Sewell DH,Gosalia KP,Kingsley EM,Oxendine JM

    更新日期:1983-09-01 00:00:00

  • Economic impact of the reduced incidence of atrial fibrillation in patients with heart failure treated with enalapril.

    abstract:BACKGROUND:Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% o...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2005.07.027

    authors: Wagner M,Rindress D,Desjardins B,Meilleur MC,Ducharme A,Tardif JC

    更新日期:2005-11-01 00:00:00

  • Effect of ambulatory blood pressure monitoring on the diagnosis and cost of treatment for mild hypertension.

    abstract::Detection of mild hypertension by a small number of casual blood pressures may be inaccurate for the determination of average blood pressure. Nonetheless, casual pressures remain the basis for the diagnosis and treatment of hypertensive patients. We compared casual and noninvasive ambulatory blood pressure monitoring ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(88)90180-9

    authors: Krakoff LR,Eison H,Phillips RH,Leiman SJ,Lev S

    更新日期:1988-10-01 00:00:00

  • Acute electrocardiographic effects of captopril in the initial treatment of malignant or severe hypertension.

    abstract::We evaluated electrocardiographically the acute effect of captopril in the initial treatment of malignant or severe hypertension and the findings were compared with the data obtained with diazoxide. The captopril group included seven patients treated with captopril or with a combination of diuretics. The diazoxide gro...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(83)90702-0

    authors: Abe I,Kawasaki T,Kawazoe N,Omae T

    更新日期:1983-09-01 00:00:00

  • Erythropoietin as a treatment of anemia in heart failure: systematic review of randomized trials.

    abstract:BACKGROUND:Anemia in heart failure is both common and associated with worse symptoms and increased mortality. Several small randomized controlled trials (RCTs) have assessed erythropoiesis-stimulating agents (ESAs), but definitive evaluation and clinical guidance are required. We sought to systematically review the eff...

    journal_title:American heart journal

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.ahj.2011.02.013

    authors: Kotecha D,Ngo K,Walters JA,Manzano L,Palazzuoli A,Flather MD

    更新日期:2011-05-01 00:00:00

  • Outcomes of cardiac pacing in adult patients after a Fontan operation.

    abstract:BACKGROUND:Cardiac pacing can be challenging after a Fontan operation, and limited data exist regarding pacing in adult Fontan patients. The objectives of our study were to determine risk factors for pacing and occurrence of device-related complications (DRCs) and pacemaker reinterventions. METHODS:We performed a retr...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2017.08.019

    authors: Egbe AC,Huntley GD,Connolly HM,Ammash NM,Deshmukh AJ,Khan AR,Said SM,Akintoye E,Warnes CA,Kapa S

    更新日期:2017-12-01 00:00:00

  • Efficacy and safety of prescription omega-3-acid ethyl esters for the prevention of recurrent symptomatic atrial fibrillation: a prospective study.

    abstract:BACKGROUND:Atrial fibrillation (AF) continues to be one of the most common cardiac problems, placing an expanding burden on the public health system. In several circumstances, AF can increase the risk of stroke and heart failure. Current pharmacologic treatment options are associated with the potential for significant ...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ahj.2009.05.024

    authors: Pratt CM,Reiffel JA,Ellenbogen KA,Naccarelli GV,Kowey PR

    更新日期:2009-08-01 00:00:00

  • Prognostic significance of the Karnofsky Performance Status score in patients with acute myocardial infarction: comparison with the left ventricular ejection fraction and the exercise treadmill test performance. The MILIS Study Group.

    abstract::The prognostic significance of functional status has not been previously studied in the setting of acute myocardial infarction. We assessed the Karnofsky Performance Status (KPS) score, a simple functional status scale that is commonly used to categorize physical ability, in 849 patients with acute myocardial infarcti...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/0002-8703(91)90141-4

    authors: Brezinski D,Stone PH,Muller JE,Tofler GH,Davis V,Parker C,Hartley LH,Braunwald E

    更新日期:1991-05-01 00:00:00

  • Abnormal changes in transmitral flow after acute exposure to nitroglycerin and nifedipine in uncomplicated insulin-dependent diabetes mellitus: a Doppler echocardiographic study.

    abstract::To study the left ventricular (LV) diastolic function in uncomplicated insulin-dependent diabetic patients without hypertension (n = 25) and comparable controls (n = 15), the effect of acute administration of nitroglycerin and nifedipine on cavity dimensions and transmitral flow pattern was investigated by Doppler ech...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(93)90542-h

    authors: Gøtzsche O,Sihm I,Lund S,Schmitz O

    更新日期:1993-12-01 00:00:00

  • A propensity analysis of the risk of vascular complications after cardiac catheterization procedures with the use of vascular closure devices.

    abstract:BACKGROUND:Complications of vascular access are one of the most common adverse events after coronary angiography and percutaneous coronary intervention (PCI) and are reported to occur in 1% to 9% of cases. There are conflicting reports of the association of vascular complications with the use of vascular closure device...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2006.12.014

    authors: Arora N,Matheny ME,Sepke C,Resnic FS

    更新日期:2007-04-01 00:00:00

  • Comparison of long-term outcomes between older Asian and white patients with non-ST-segment elevation myocardial infarction: findings from CRUSADE-CMS database.

    abstract:BACKGROUND:In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes. METHODS:We linked Centers for Medicare & Medicaid claims data to detailed clinical data for 37...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2013.10.001

    authors: Xu W,Holmes DN,Becker RC,Roe MT,Peterson ED,Wang TY

    更新日期:2013-12-01 00:00:00

  • Accuracy of three-dimensional echocardiography with unrestricted selection of imaging planes for measurement of left ventricular volumes and ejection fraction.

    abstract:BACKGROUND:Accurate, reproducible, noninvasive determination of left ventricular (LV) volumes and ejection fraction (EF) is important for clinical assessment, risk stratification, selection of therapy, and serial monitoring of patients with cardiovascular disease. Three-dimensional echocardiography (3DE) approaches hav...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章

    doi:10.1067/mhj.2000.108513

    authors: Hibberd MG,Chuang ML,Beaudin RA,Riley MF,Mooney MG,Fearnside JT,Manning WJ,Douglas PS

    更新日期:2000-09-01 00:00:00

  • Ventricular arrhythmias in dilated cardiomyopathy: efficacy of amiodarone.

    abstract::Sixty-five patients with dilated cardiomyopathy were studied by means of 24-hour ECG monitoring. Ventricular arrhythmias were present in 62 (95.4%), of whom 52 (80%) showed a complex form (multiform ventricular extrasystoles, pairs, and ventricular tachycardia). Forty-one patients, presenting with complex ventricular ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(87)90711-3

    authors: Neri R,Mestroni L,Salvi A,Pandullo C,Camerini F

    更新日期:1987-03-01 00:00:00

  • Echocardiographic characterization of left ventricular adaptation in a genetically determined heart failure rat model.

    abstract::This study uses echocardiography to characterize the pattern of left ventricular hypertrophy in a new hypertensive heart failure-prone rat strain designated SHHF/Mcc-cp (SHHF). M-mode echocardiograms of the left ventricle in nine 10- to 12-month old SHHF rats and nine age-matched spontaneously hypertensive rats (SHR) ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(95)90081-0

    authors: Haas GJ,McCune SA,Brown DM,Cody RJ

    更新日期:1995-10-01 00:00:00

  • Oxygen uptake efficiency slope, a new submaximal parameter in evaluating exercise capacity in chronic heart failure patients.

    abstract:BACKGROUND:The oxygen uptake efficiency slope (OUES) is a new submaximal parameter which objectively predicts the maximal exercise capacity in children and healthy subjects. However, the usefulness of OUES in adult patients with and without advanced heart failure remains undetermined. The present study investigates the...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2004.07.004

    authors: Van Laethem C,Bartunek J,Goethals M,Nellens P,Andries E,Vanderheyden M

    更新日期:2005-01-01 00:00:00

  • Resting thallium-201 myocardial perfusion patterns in patients with severe left ventricular dysfunction: differences between patients with primary cardiomyopathy, chronic coronary artery disease, or acute myocardial infarction.

    abstract::This study examined the value of resting thallium-201 imaging in differentiating patients with primary cardiomyopathy from those with ischemic cardiomyopathy. There were 15 patients with primary cardiomyopathy (group I); 20 with chronic CAD (group II); and 25 with acute Q wave myocardial infarction (group III). All pa...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(86)90113-4

    authors: Iskandrian AS,Hakki AH,Kane S

    更新日期:1986-04-01 00:00:00

  • Sequential changes in regional coronary flow during pacing-induced angina pectoris: coronary flow limitation precedes angina.

    abstract::To investigate the sequence of changes in regional myocardial perfusion which precedes stress-induced angina, we measured great cardiac vein flow (GCVF), draining the anterior left ventricle, during incremental atrial pacing in 10 patients with normal anterior perfusion (group I) and in 11 patients with greater than o...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(84)90374-0

    authors: Wilson JR,Martin JL,Untereker WJ,Laskey W,Hirshfeld JW

    更新日期:1984-02-01 00:00:00

  • Recovery of left ventricular function in acute nonischemic congestive cardiomyopathy.

    abstract::The extent and time course of recovery of left ventricular function were investigated in 29 patients with no previous symptoms who had acute nonischemic congestive cardiomyopathy and left ventricular ejection fraction of 0.22 +/- 0.07. Improvement in left ventricular ejection fraction by at least 0.05 was observed in ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(95)90038-1

    authors: Cross AM Jr,Steenbergen C,Higginbotham MB

    更新日期:1995-01-01 00:00:00

  • Efficacy and safety of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.

    abstract:BACKGROUND:We compared efficacy and safety of short- (3 or 6 months) versus long-term (≥12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS:Patient-level pooled analysis was performed with 7242 patients (87.2% with ...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ahj.2017.11.013

    authors: Hwang D,Park KW,Lee JM,Rhee TM,Hong MK,Jang Y,Valgimigli M,Colombo A,Gilard M,Palmerini T,Stone GW,Kim HS

    更新日期:2018-03-01 00:00:00

  • Percutaneous transluminal coronary recanalization: procedure, results, and acute complications.

    abstract::Percutaneous transluminal coronary recanalization, a new therapeutic procedure used in acute myocardial infarction, offers significant reduction in mortality, as well as more effective limitation of the zone of infarction than has been possible with other pharmacologic treatment employed in the past. The risk of coron...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(81)90649-9

    authors: Rutsch W,Schartl M,Mathey D,Kuck K,Merx W,Dörr R,Rentrop P,Blanke H

    更新日期:1981-12-01 00:00:00

  • Effects of hyperoxia on myocardial injury following cardioversion-A randomized clinical trial.

    abstract::Oxygen has long been assumed beneficial for all ill and injured patients. However, hyperoxia may be harmful and aggravate myocardial injury such as that caused by myocardial infarction. We aimed to investigate if hyperoxia increases myocardial injury following direct current cardioversion compared with room air. METH...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ahj.2017.10.006

    authors: Lauridsen KG,Schmidt AS,Adelborg K,Bach L,Hornung N,Jepsen SM,Deakin CD,Rickers H,Løfgren B

    更新日期:2018-02-01 00:00:00

  • Use of rapid serial sampling of creatine kinase MB for very early detection of myocardial infarction in patients with acute chest pain.

    abstract::To determine how early myocardial infarction can be detected, serial creatine kinase MB concentrations were sampled in 313 patients during triage of acute (less than 12 hours) chest pain. Serum was sampled on hospital arrival (baseline) and hourly for 3 hours (total of four samples). Creatine kinase MB concentrations ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(92)90646-d

    authors: Marin MM,Teichman SL

    更新日期:1992-02-01 00:00:00