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Low-energy defibrillation: safe and effective.

C L Lake, T D Sellers, S P Nolan

    The American Journal of Emergency Medicine
    |March 1, 1985
    PubMed
    Summary
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    Low-energy defibrillation is feasible during cardiopulmonary bypass for cardiac surgery patients. Direct current (DC) shocks at 2.5 J showed a 58% success rate, with success plateauing above this level.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Electrophysiology

    Background:

    • Cardiopulmonary bypass is frequently used in cardiac surgery.
    • Ventricular fibrillation is a potential complication during this procedure.
    • Effective defibrillation strategies are crucial for patient outcomes.

    Purpose of the Study:

    • To evaluate the efficacy of direct current (DC) shocks for terminating ventricular fibrillation during cardiopulmonary bypass.
    • To determine the optimal energy levels and success rates for defibrillation in this context.
    • To assess myocardial resistance during defibrillation attempts.

    Main Methods:

    • Prospective evaluation of 150 cardiac surgical patients undergoing cardiopulmonary bypass.
    • Analysis of the number, energy, current, and success rates of DC shocks.

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  • Measurement of myocardial resistance before and during defibrillation.

    • Main Results:

    • Defibrillation success rates were 31% for 1-J shocks and 58% for 2.5-J shocks.
    • Success rates plateaued at 50-60% for energies above 2.5 J.
    • Myocardial resistance decreased significantly after the first shock but remained stable thereafter.

    Conclusions:

    • Low-energy defibrillation is feasible during cardiopulmonary bypass.
    • Observed defibrillating currents and myocardial resistances were lower than previously reported.
    • These findings support the use of lower energy levels for defibrillation in this patient population.