体外式電気ショックによる心室細動誘発の電気生理学的特性と除細動閾値との関係 : 犬を用いた実験的検討

概要

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Although transthoracic direct current electric shock (DC) is the established method for termination of ventricular fibrillation (Vf), it can also induce Vf if administered during the ventricular vulnerable period. Therefore, in order to improve the safety and efficacy of DC therapy, the relationship between the energy levels required to induced Vf and the energy levels required to successfully defibrillate by DC must be better understood. Transthoracic DCs were delivered to sixteen mongrel dogs (8 normal hearts [NH]; 8 infarcted hearts [IH]). Various shock intensity (1 to 100 J) and shock timings (coupling intervals from the spontaneous sinus rhythm with a 10 ms scanning interval) were given and Vf inducibility was observed. When Vf was induced, defibrillation trials were performed to measure the 50% defibrillation threshold (DFT). Electrical potentials were also measured at 8 and 20 J DC intensity. An upper limit of Vf inducingenergy levels (ULV) was observed at 14.0 ±6.9 J in NH and 15.6 ± 14.5 J in IH. DFT was 26.8 ± 14.6 J in NH and 33.8 ± 20.0 J in IH. There were nosignificant differences in ULV or DFT between NH and IH. The DFT was significantly higher than the ULV (p<0.05), and a direct correlation existed between ULV and DFT (DFT=1.263 ULV + 11.6, r=0.8, p<0.001). These results support the upper limit of vulnerability hypothesis in transthoracic DC defibrillation.
1996-12-25