Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability

Peng-Sheng Chen, N. Shibata, E. G. Dixon, R. O. Martin, R. E. Ideker

Research output: Contribution to journalArticle

210 Citations (Scopus)

Abstract

To examine the relationship between the defibrillation threshold and the strength of shocks that induce ventricular fibrillation during the vulnerable period, we determined the defibrillation threshold in 22 open-chest dogs using epicardial defibrillation electrodes with the cathode at the ventricular apex and the anode at the right atrium. We also determined whether there was an upper limit of shock strength that induces fibrillation in the vulnerable period by giving shocks of various energy through these same electrodes during the repolarization phase of paced rhythm. The above determinations were also made with the anode at the ventricular apex and the cathode at the right atrium in eight of the dogs and with the cathode at the ventricular apex and the anode at the left atrium in another eight of the dogs. In all dogs for all electrode configurations, there was an upper limit to the shock strength that induced ventricular fibrillation during the vulnerable period. Depending on the electrode combination, this upper limit of ventricular vulnerability either was not significantly different from or was slightly lower than the defibrillation threshold. The correlation coefficient between the two was highly significant for all three electrode configurations. These results support the hypothesis that successful defibrillation with epicardial electrodes requires a shock strength that reaches or exceeds the upper limit of ventricular vulnerability and that shocks slightly lower than the defibrillation threshold fail because they reinitiate ventricular fibrillation by stimulating portions of the myocardium during their vulnerable period.

Original languageEnglish (US)
Pages (from-to)1022-1028
Number of pages7
JournalCirculation
Volume73
Issue number5
StatePublished - 1986
Externally publishedYes

Fingerprint

Electrodes
Shock
Ventricular Fibrillation
Heart Atria
Dogs
Myocardium
Thorax

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Chen, P-S., Shibata, N., Dixon, E. G., Martin, R. O., & Ideker, R. E. (1986). Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability. Circulation, 73(5), 1022-1028.

Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability. / Chen, Peng-Sheng; Shibata, N.; Dixon, E. G.; Martin, R. O.; Ideker, R. E.

In: Circulation, Vol. 73, No. 5, 1986, p. 1022-1028.

Research output: Contribution to journalArticle

Chen, P-S, Shibata, N, Dixon, EG, Martin, RO & Ideker, RE 1986, 'Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability', Circulation, vol. 73, no. 5, pp. 1022-1028.
Chen, Peng-Sheng ; Shibata, N. ; Dixon, E. G. ; Martin, R. O. ; Ideker, R. E. / Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability. In: Circulation. 1986 ; Vol. 73, No. 5. pp. 1022-1028.
@article{48393c05209d4f37926266e91b2addac,
title = "Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability",
abstract = "To examine the relationship between the defibrillation threshold and the strength of shocks that induce ventricular fibrillation during the vulnerable period, we determined the defibrillation threshold in 22 open-chest dogs using epicardial defibrillation electrodes with the cathode at the ventricular apex and the anode at the right atrium. We also determined whether there was an upper limit of shock strength that induces fibrillation in the vulnerable period by giving shocks of various energy through these same electrodes during the repolarization phase of paced rhythm. The above determinations were also made with the anode at the ventricular apex and the cathode at the right atrium in eight of the dogs and with the cathode at the ventricular apex and the anode at the left atrium in another eight of the dogs. In all dogs for all electrode configurations, there was an upper limit to the shock strength that induced ventricular fibrillation during the vulnerable period. Depending on the electrode combination, this upper limit of ventricular vulnerability either was not significantly different from or was slightly lower than the defibrillation threshold. The correlation coefficient between the two was highly significant for all three electrode configurations. These results support the hypothesis that successful defibrillation with epicardial electrodes requires a shock strength that reaches or exceeds the upper limit of ventricular vulnerability and that shocks slightly lower than the defibrillation threshold fail because they reinitiate ventricular fibrillation by stimulating portions of the myocardium during their vulnerable period.",
author = "Peng-Sheng Chen and N. Shibata and Dixon, {E. G.} and Martin, {R. O.} and Ideker, {R. E.}",
year = "1986",
language = "English (US)",
volume = "73",
pages = "1022--1028",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Comparison of the defibrillation threshold and the upper limit of ventricular vulnerability

AU - Chen, Peng-Sheng

AU - Shibata, N.

AU - Dixon, E. G.

AU - Martin, R. O.

AU - Ideker, R. E.

PY - 1986

Y1 - 1986

N2 - To examine the relationship between the defibrillation threshold and the strength of shocks that induce ventricular fibrillation during the vulnerable period, we determined the defibrillation threshold in 22 open-chest dogs using epicardial defibrillation electrodes with the cathode at the ventricular apex and the anode at the right atrium. We also determined whether there was an upper limit of shock strength that induces fibrillation in the vulnerable period by giving shocks of various energy through these same electrodes during the repolarization phase of paced rhythm. The above determinations were also made with the anode at the ventricular apex and the cathode at the right atrium in eight of the dogs and with the cathode at the ventricular apex and the anode at the left atrium in another eight of the dogs. In all dogs for all electrode configurations, there was an upper limit to the shock strength that induced ventricular fibrillation during the vulnerable period. Depending on the electrode combination, this upper limit of ventricular vulnerability either was not significantly different from or was slightly lower than the defibrillation threshold. The correlation coefficient between the two was highly significant for all three electrode configurations. These results support the hypothesis that successful defibrillation with epicardial electrodes requires a shock strength that reaches or exceeds the upper limit of ventricular vulnerability and that shocks slightly lower than the defibrillation threshold fail because they reinitiate ventricular fibrillation by stimulating portions of the myocardium during their vulnerable period.

AB - To examine the relationship between the defibrillation threshold and the strength of shocks that induce ventricular fibrillation during the vulnerable period, we determined the defibrillation threshold in 22 open-chest dogs using epicardial defibrillation electrodes with the cathode at the ventricular apex and the anode at the right atrium. We also determined whether there was an upper limit of shock strength that induces fibrillation in the vulnerable period by giving shocks of various energy through these same electrodes during the repolarization phase of paced rhythm. The above determinations were also made with the anode at the ventricular apex and the cathode at the right atrium in eight of the dogs and with the cathode at the ventricular apex and the anode at the left atrium in another eight of the dogs. In all dogs for all electrode configurations, there was an upper limit to the shock strength that induced ventricular fibrillation during the vulnerable period. Depending on the electrode combination, this upper limit of ventricular vulnerability either was not significantly different from or was slightly lower than the defibrillation threshold. The correlation coefficient between the two was highly significant for all three electrode configurations. These results support the hypothesis that successful defibrillation with epicardial electrodes requires a shock strength that reaches or exceeds the upper limit of ventricular vulnerability and that shocks slightly lower than the defibrillation threshold fail because they reinitiate ventricular fibrillation by stimulating portions of the myocardium during their vulnerable period.

UR - http://www.scopus.com/inward/record.url?scp=0022598194&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022598194&partnerID=8YFLogxK

M3 - Article

C2 - 3698224

AN - SCOPUS:0022598194

VL - 73

SP - 1022

EP - 1028

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 5

ER -