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Thoracotomy elevates the defibrillation threshold and modifies the defibrillation dose-response curve

P A Friedman¹, M S Stanton

¹Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.

Journal of Cardiovascular Electrophysiology

|January 1, 1997

Summary

Thoracotomy temporarily increases defibrillation energy requirements and alters the dose-response curve in canine models. This finding is crucial for understanding defibrillation efficacy after chest surgery.

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Area of Science:

Cardiovascular Research
Medical Device Engineering

Background:

Thoracotomy remains necessary in clinical and research settings despite advancements in non-surgical defibrillation.
The impact of thoracotomy on defibrillation energy needs has not been thoroughly investigated.

Purpose of the Study:

To characterize the effect of thoracotomy on defibrillation energy requirements and dose-response curves.

Main Methods:

Ten dogs underwent immediate defibrillation testing post-thoracotomy.
Ten dogs received 48-72 hours recovery before defibrillation testing.
A right ventricular endocardial coil to cutaneous thoracic patch biphasic system was employed.

Main Results:

The immediate group exhibited higher heart rates, pulmonary artery pressures, and shock impedance compared to the delayed group.

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Mean ED50 (energy for 50% success) was significantly higher in the immediate group (26.9 J vs 14.2 J).

Defibrillation dose-response curves differed significantly between groups (P=0.03).

Conclusions:

Thoracotomy significantly and transiently elevates the defibrillation threshold.
The defibrillation dose-response curve is modified by thoracotomy in this specific system.