Ventricular pacing threshold and refractoriness after defibrillation shocks in patients with implantable cardioverter-defibrillators.

Abstract:

:The aim of this study was to examine the effect of ventricular fibrillation and a subsequent defibrillation shock on ventricular excitability and refractoriness in human beings. We studied 16 consecutive patients with implantable cardioverter-defibrillators undergoing follow-up studies. The pre- and post-shock pacing threshold, ventricular effective refractory period, monophasic action potential duration, and serum catecholamine levels were measured. Compared with the baseline state, immediately after ventricular fibrillation, and a successful defibrillation shock: (1) the ventricular effective refractory period decreased from 251 +/- 24 ms to 222 +/- 30 ms (p < 0.01), (2) the monophasic action potential duration decreased from 210 +/- 16 ms to 179 +/- 23 ms (P < 0.01) at 50% repolarization and from 274 +/- 24 ms to 240 +/- 26 ms (P< 0.01) at 90% repolarization, (3) the pacing threshold was not significantly altered and, (4) serum levels of epinephrine and norepinephrine were elevated. These results show that although ventricular fibrillation and subsequent defibrillation had no effect on the ventricular pacing threshold in human beings, it was associated with a decrease in post-shock monophasic action potential duration and ventricular effective refractory period, contrary to some previously reported findings.

journal_name

Am Heart J

journal_title

American heart journal

authors

Yu JC,Lauer MR,Young C,Liem B,Peterson J,Ottoboni L,Sung RJ

doi

10.1016/s0002-8703(96)90086-1

subject

Has Abstract

pub_date

1996-06-01 00:00:00

pages

1121-6

issue

6

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(96)90086-1

journal_volume

131

pub_type

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