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