Kroll Mark W, Walcott Gregory P, Ideker Raymond E, Graham Michael A, Calkins Hugh, Lakkireddy Dhanunjaya, Luceri Richard M, Panescu Dorin
Biomedical Engineering Dept., University of Minnesota, Minneapolis, MN, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:6377-81. doi: 10.1109/EMBC.2012.6347453.
The first recorded heart rhythm for cardiac arrest patients can either be ventricular fibrillation (VF) which is treatable with a defibrillator, or asystole or pulseless electrical activity (PEA) which are not. The time course for the deterioration of VF to either asystole or PEA is not well understood. Knowing the time course of this deterioration may allow for improvements in emergency service delivery. In addition, this may improve the diagnosis of possible electrocutions from various electrical sources including utility power, electric fences, or electronic control devices (ECDs) such as a TASER(®) ECD. We induced VF in 6 ventilated swine by electrically maintaining rapid cardiac capture, with resulting hypotension, for 90 seconds. No circulatory assistance was provided. They were then monitored for 40 minutes via an electrode in the right ventricle. Only 2 swine remained in VF; 3 progressed to asystole; 1 progressed to PEA. These results were used in a logistic regression model. The results are then compared to published animal and human data. The median time for the deterioration of electrically induced VF in the swine was 35 minutes. At 24 minutes VF was still maintained in all of the animals. We conclude that electrically induced VF is long-lived--even in the absence of chest compressions.
心脏骤停患者首次记录的心律要么是可用除颤器治疗的心室颤动（VF），要么是不可用除颤器治疗的心脏停搏或无脉电活动（PEA）。VF恶化为心脏停搏或PEA的时间进程尚不清楚。了解这种恶化的时间进程可能有助于改善急救服务。此外，这可能有助于改善对各种电源（包括公用事业电力、电围栏或电子控制设备（ECD），如泰瑟枪（®）ECD）可能导致的触电的诊断。我们通过电维持快速心脏捕获诱导6只通气猪发生VF，持续90秒，导致低血压。未提供循环辅助。然后通过右心室电极对它们进行40分钟的监测。只有2只猪仍处于VF状态；3只进展为心脏停搏；1只进展为PEA。这些结果用于逻辑回归模型。然后将结果与已发表的动物和人类数据进行比较。猪中电诱导VF恶化的中位时间为35分钟。在24分钟时，所有动物仍维持VF状态。我们得出结论，即使在没有胸外按压的情况下，电诱导VF也能持续很长时间。
