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Shock wave lithotripsy with the Dornier MFL 5000 lithotriptor using an external fixed rate signal
J E Lingeman1, D M Newman, Y I Siegel
1Methodist Hospital Institute for Kidney Stone Disease, Indianapolis, USA.
Purpose:
We examine the effects of fixed rate shock wave administration on the cardiac rhythm and treatment efficacy of a tubless lithotriptor (Dornier MFL 5000*). A secondary goal was to examine the treatment efficacy of fixed shock wave administration compared to R wave triggered lithotripsy.
Materials And Methods:
In this prospective study Holter monitoring was used before, during and after nonR wave triggered shock wave lithotripsy.
Results:
An increase in premature ventricular contractions was noted during shock wave lithotripsy. However, there were no episodes of significant ventricular ectopia, ventricular tachycardia, asystole or heart block as a result of nonR wave triggered shock wave administration. NonR wave gated shock wave lithotripsy expedited patient treatment and (mean treatment time 46 +/- 21 minutes)., minimized the use of sedation during treatment and produced results similar to R wave gated shock wave lithotripsy with the MFL 5000 lithotriptor.
Conclusions:
With adequate precautions, fixed rate shock wave administration would appear to be a reasonable option to treat urolithiasis with the MFL 5000 lithotriptor as with other newer lithotriptors.