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Electrophysiologic changes induced by external transthoracic countershock.

G J Anderson, J Reiser

    Journal of Electrocardiology
    |April 1, 1983
    PubMed
    Summary
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    Suprathreshold transthoracic shocks can cause significant cardiac electrical disturbances, including arrhythmias like ventricular tachycardia. These shocks lead to cellular injury and altered electrophysiological properties, potentially increasing the risk of dangerous heart rhythms.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Surgery

    Background:

    • Transthoracic shocks are used in critical care settings.
    • Understanding the electrophysiological consequences of these shocks is crucial for patient safety.
    • Previous research has not fully characterized the detailed cellular and functional changes induced by suprathreshold shocks.

    Purpose of the Study:

    • To investigate the electrophysiological effects of suprathreshold transthoracic shocks on cardiac function.
    • To identify specific cellular and functional changes in the heart following these electrical interventions.

    Main Methods:

    • Anesthetized dogs received two consecutive suprathreshold transthoracic shocks (10 joules/kg).
    • Cardiac electrophysiological parameters were assessed immediately post-shock and 48 hours later.

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  • Histological examination of cardiac tissue was performed to identify cellular injury.
  • Main Results:

    • Ventricular extrasystoles, A-V block, ventricular tachycardia, and asystole were observed acutely.
    • Post-mortem analysis revealed cellular injury, including loss of resting potential and action potential abnormalities.
    • Shortened functional refractory periods, action potential alternans, and conduction delays were identified.
    • Histological findings showed sub-epicardial injury.

    Conclusions:

    • Suprathreshold transthoracic shocks induce significant acute and sub-acute electrophysiological alterations in the heart.
    • These changes, including cellular injury and conduction abnormalities, may predispose the heart to tachyarrhythmias.
    • Further research is needed to optimize shock parameters and mitigate risks.