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Clinical Efficacy of a Wearable Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation Using Biphasic Shocks.

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Title: Clinical Efficacy of a Wearable Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation Using Biphasic Shocks.
Authors: REEK, SVEN1 (AUTHOR), GELLER, J. CHRISTOPH1 (AUTHOR), MELTENDORF, ULF1 (AUTHOR), WOLLBRUECK, ANKE1 (AUTHOR), SZYMKIEWICZ, STEVEN J.2 (AUTHOR), KLEIN, HELMUT U.1 (AUTHOR)
Source: Pacing & Clinical Electrophysiology. Oct2003, Vol. 26 Issue 10, p2016-2022. 7p.
Subjects: Defibrillators, Ventricular fibrillation, Cardiac arrest, Resuscitation, Arrhythmia
Abstract: The Wearable Cardioverter Defibrillator (WCD) automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander, while at the same time allowing the patient to ambulate freely. It represents an alternative to emergency medical services for outpatient populations with a temporary risk of sudden cardiac death. While the original devices used a monophasic truncated exponential waveform for cardioversion/defibrillation shocks, a new, biphasic shock was developed for the next device generation. In 12 patients undergoing electrophysiological testing for ventricular tachyarrhythmias, termination of electrically induced ventricular fibrillation (VF) was attempted via the WCD. In 22 episodes, induced VF was promptly terminated by the first 70 J (n = 12) or 100 J (n = 10) biphasic shocks. Time between arrhythmia initiation and shock delivery was 22 ± 6 seconds (70 J) and 21 ± 6 seconds (100 J) (P = NS). The measured transthoracic impedance was 71 ± 5 Ω (64–79 Ω) for the 70 J shock and 64 ± 8 Ω (47–72 Ω) for the 100 J shock. The present study demonstrates that a single low energy biphasic shock delivered by the WCD, reliably terminates electrically induced VF (100% of episodes). The results of this study suggest that there is an acceptable safety margin to the maximum output of the device (150 J). Despite our promising data, we recommend that programming all shocks for maximum energy output should be done when using the WCD in ambulatory patients. (PACE 2003; 26:2016–2022) [ABSTRACT FROM AUTHOR]
Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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PubType: Academic Journal
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  Data: Clinical Efficacy of a Wearable Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation Using Biphasic Shocks.
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  Data: <searchLink fieldCode="JN" term="%22Pacing+%26+Clinical+Electrophysiology%22">Pacing & Clinical Electrophysiology</searchLink>. Oct2003, Vol. 26 Issue 10, p2016-2022. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Defibrillators%22">Defibrillators</searchLink><br /><searchLink fieldCode="DE" term="%22Ventricular+fibrillation%22">Ventricular fibrillation</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiac+arrest%22">Cardiac arrest</searchLink><br /><searchLink fieldCode="DE" term="%22Resuscitation%22">Resuscitation</searchLink><br /><searchLink fieldCode="DE" term="%22Arrhythmia%22">Arrhythmia</searchLink>
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  Data: The Wearable Cardioverter Defibrillator (WCD) automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander, while at the same time allowing the patient to ambulate freely. It represents an alternative to emergency medical services for outpatient populations with a temporary risk of sudden cardiac death. While the original devices used a monophasic truncated exponential waveform for cardioversion/defibrillation shocks, a new, biphasic shock was developed for the next device generation. In 12 patients undergoing electrophysiological testing for ventricular tachyarrhythmias, termination of electrically induced ventricular fibrillation (VF) was attempted via the WCD. In 22 episodes, induced VF was promptly terminated by the first 70 J (n = 12) or 100 J (n = 10) biphasic shocks. Time between arrhythmia initiation and shock delivery was 22 ± 6 seconds (70 J) and 21 ± 6 seconds (100 J) (P = NS). The measured transthoracic impedance was 71 ± 5 Ω (64–79 Ω) for the 70 J shock and 64 ± 8 Ω (47–72 Ω) for the 100 J shock. The present study demonstrates that a single low energy biphasic shock delivered by the WCD, reliably terminates electrically induced VF (100% of episodes). The results of this study suggest that there is an acceptable safety margin to the maximum output of the device (150 J). Despite our promising data, we recommend that programming all shocks for maximum energy output should be done when using the WCD in ambulatory patients. (PACE 2003; 26:2016–2022) [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1046/j.1460-9592.2003.00311.x
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      – Code: eng
        Text: English
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        StartPage: 2016
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      – SubjectFull: Defibrillators
        Type: general
      – SubjectFull: Ventricular fibrillation
        Type: general
      – SubjectFull: Cardiac arrest
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      – SubjectFull: Resuscitation
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      – SubjectFull: Arrhythmia
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    Titles:
      – TitleFull: Clinical Efficacy of a Wearable Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation Using Biphasic Shocks.
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              Text: Oct2003
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              Y: 2003
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