Double and triple sequential shocks reduce ventricular defibrillation threshold in dogs with and without myocardial infarction

Mau Song Chang, Hiroshi Inoue, Michael J. Kallok, Douglas P. Zipes

Research output: Contribution to journalArticle

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Abstract

The role of optimal placement of electrodes and mode of shock delivery from a defibrillator was examined in dogs with and without myocardial infarction. Single, double and triple truncated exponential shocks separated by 1 ms were delivered through various electrode combinations and cardiac vectors after electrical inductions of ventricular fibrillation. A single shock through a pathway not incorporating the interventricular septum (catheter electrodes or epicardial patches between anterior and posterior left ventricle) required the highest total energy (22.6 and > 26.4 J, respectively) and peak voltage (1,004 and > 1,094 V, respectively) to terminate ventricular fibrillation. A single shock through a pathway including the interventricular septum required lower total energy and peak voltage to defibrillate. Combinations of two sequential shocks between an intracardiac catheter electrode and anterior left ventricular epicardial patch, between the catheter electrode and subcutaneous extrathoracic plate and between three ventricular epicardial patches all significantly reduced total energy (7.7, 8.7 and 7.8 J, respectively) and peak voltage (424, 436 and 424 V, respectively) needed to defibrillate. Three sequential shocks exerted no significant additional reduction in total energy of the defibrillation threshold than did two sequential shocks. Infarcted canine heart required less peak voltage but not total energy to terminate ventricular fibrillation than did noninfarcted heart. Therefore, two sequential shocks over different pathways reduce both total energy and peak voltage required to terminate ventricular fibrillation.

Original languageEnglish (US)
Pages (from-to)1393-1405
Number of pages13
JournalJournal of the American College of Cardiology
Volume8
Issue number6
DOIs
StatePublished - Jan 1 1986

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Shock
Myocardial Infarction
Dogs
Ventricular Fibrillation
Electrodes
Catheters
Cardiac Catheters
Defibrillators
Heart Ventricles
Canidae

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Double and triple sequential shocks reduce ventricular defibrillation threshold in dogs with and without myocardial infarction. / Chang, Mau Song; Inoue, Hiroshi; Kallok, Michael J.; Zipes, Douglas P.

In: Journal of the American College of Cardiology, Vol. 8, No. 6, 01.01.1986, p. 1393-1405.

Research output: Contribution to journalArticle

Chang, Mau Song ; Inoue, Hiroshi ; Kallok, Michael J. ; Zipes, Douglas P. / Double and triple sequential shocks reduce ventricular defibrillation threshold in dogs with and without myocardial infarction. In: Journal of the American College of Cardiology. 1986 ; Vol. 8, No. 6. pp. 1393-1405.
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