A Low Tilt Waveform in the Transthoracic Defibrillation of Ventricular Arrhythmias during Cardiac Arrest

Resuscitation, 05/11/2012

Darragh KM et al. – The low tilt waveform used in this study demonstrated first shock success rates in keeping with a commercially available high tilt defibrillator which could result in less myocardial damage due to reduced energy requirements.

Methods

  • Patients in cardiac arrest who experienced ventricular arrhythmias received shocks from a novel low tilt waveform defibrillator at 120J or a standard tilt waveform defibrillator at 150J.
  • Resuscitation guidelines were followed as per Resuscitation Council UK, 2005.
  • A shock was successful when the ventricular arrhythmia was terminated for ≥5seconds following shock delivery.

Results

  • A total of 113 cardiac arrest cases were included.
  • The low tilt device was used for 56 cases and the standard tilt device for 57 cases.
  • The presenting rhythm was ventricular fibrillation (VF) in 71.7% (81/113), pulseless electrical activity (PEA) in 15.9% (18/113), ventricular tachycardia (VT) in 9.7% (11/113), asystole in 1.8% (2/113) and narrow complex rhythm in 0.9% (1/113).
  • The low tilt device resulted in first shock success in 86% (48/56 cases) versus the standard tilt device first shock success of 77% (44/57 cases).
  • There was no significant difference in first shock success between the two devices (p=0.36).

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