Shortening the second phase duration of biphasic shocks: Effects of class III antiarrhythmic drugs on defibrillation efficacy in humans

B. Merkely, Andrzej Lubiński, Orsolya Kiss, F. Horkay, Eva Lewicka-Nowak, Maciej Kempa, Zoltán Szabolcs, György Nyikos, E. Zima, Grazyna Świa̧tecka, L. Gellér

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: The specific waveform providing optimal defibrillation threshold (DFT) is unknown. We compared the defibrillation efficacy of biphasic pulses with second phases (P2) of 2 and 5 msec in a randomized prospective clinical study. Methods and Results: Intraoperative DFTs of 62 patients (age 54 ± 13 years; ejection fraction 43% ± 17%; amiodarone 47%, d,l-sotalol 13%) were determined in random order using a binary search protocol. Anodal shocks of 60% tilt first phases (P1) and P2 of 2 msec/5 msec were delivered from two 100-μF capacitors between the right ventricular electrode and the test housing of a Phylax 06/XM device. Mean DFT was significantly lower using the shorter P2 (9.5 ± 4.5 J vs 11.3 ± 5.2 J; P <0.0001). According to subgroup analysis, the effect of changing P2 duration was only influenced by antiarrhythmic treatment. DFT decreased markedly using the shorter P2 in patients treated with amiodarone (10.7 ± 4.9 J vs 13.4 ± 5.6 J; P <0.00001) or d,l-sotalol (6.1 ± 3.3 J vs 9.1 ± 4.6 J; P <0.05). The difference in patients not treated with Class III drugs was found to be insignificant. Chronic amiodarone treatment increased DFT only when the longer P2 was used. Conclusion: Biphasic shocks with shorter P2 should be used in patients undergoing Class III antiarrhythmic treatment.

Original languageEnglish
Pages (from-to)824-827
Number of pages4
JournalJournal of Cardiovascular Electrophysiology
Volume12
Issue number7
Publication statusPublished - 2001

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Anti-Arrhythmia Agents
Amiodarone
Shock
Sotalol
Electrodes
Therapeutics
Prospective Studies
Equipment and Supplies
Pharmaceutical Preparations

Keywords

  • Defibrillation
  • Drugs
  • Shock

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Shortening the second phase duration of biphasic shocks : Effects of class III antiarrhythmic drugs on defibrillation efficacy in humans. / Merkely, B.; Lubiński, Andrzej; Kiss, Orsolya; Horkay, F.; Lewicka-Nowak, Eva; Kempa, Maciej; Szabolcs, Zoltán; Nyikos, György; Zima, E.; Świa̧tecka, Grazyna; Gellér, L.

In: Journal of Cardiovascular Electrophysiology, Vol. 12, No. 7, 2001, p. 824-827.

Research output: Contribution to journalArticle

Merkely, B. ; Lubiński, Andrzej ; Kiss, Orsolya ; Horkay, F. ; Lewicka-Nowak, Eva ; Kempa, Maciej ; Szabolcs, Zoltán ; Nyikos, György ; Zima, E. ; Świa̧tecka, Grazyna ; Gellér, L. / Shortening the second phase duration of biphasic shocks : Effects of class III antiarrhythmic drugs on defibrillation efficacy in humans. In: Journal of Cardiovascular Electrophysiology. 2001 ; Vol. 12, No. 7. pp. 824-827.
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abstract = "Introduction: The specific waveform providing optimal defibrillation threshold (DFT) is unknown. We compared the defibrillation efficacy of biphasic pulses with second phases (P2) of 2 and 5 msec in a randomized prospective clinical study. Methods and Results: Intraoperative DFTs of 62 patients (age 54 ± 13 years; ejection fraction 43{\%} ± 17{\%}; amiodarone 47{\%}, d,l-sotalol 13{\%}) were determined in random order using a binary search protocol. Anodal shocks of 60{\%} tilt first phases (P1) and P2 of 2 msec/5 msec were delivered from two 100-μF capacitors between the right ventricular electrode and the test housing of a Phylax 06/XM device. Mean DFT was significantly lower using the shorter P2 (9.5 ± 4.5 J vs 11.3 ± 5.2 J; P <0.0001). According to subgroup analysis, the effect of changing P2 duration was only influenced by antiarrhythmic treatment. DFT decreased markedly using the shorter P2 in patients treated with amiodarone (10.7 ± 4.9 J vs 13.4 ± 5.6 J; P <0.00001) or d,l-sotalol (6.1 ± 3.3 J vs 9.1 ± 4.6 J; P <0.05). The difference in patients not treated with Class III drugs was found to be insignificant. Chronic amiodarone treatment increased DFT only when the longer P2 was used. Conclusion: Biphasic shocks with shorter P2 should be used in patients undergoing Class III antiarrhythmic treatment.",
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AU - Kiss, Orsolya

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AU - Lewicka-Nowak, Eva

AU - Kempa, Maciej

AU - Szabolcs, Zoltán

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