Ewy G A
Circulation. 1986 Dec;74(6 Pt 2):IV111-6.
This presentation summarizes advances in electrical therapy of cardiovascular emergencies. The urgency of delivering definitive therapy is emphasized, and the roles of automatic internal and external defibrillators, practical external pacing, and mechanical techniques for cardioversion and defibrillation are evaluated. Standard position of the electroplates is recommended except in patients who have permanently implanted pacemakers. In these patients, the defibrillation electrodes should be at least 5 inches from the pacemaker generator. The energy requirement for defibrillation of ventricular fibrillation is reviewed, with the conclusion that the initial defibrillatory shock should be 200 J. The determinants of the transthoracic impedance are important, especially if low-energy shocks are to be used, since a high transthoracic impedance results in a poor success rate for defibrillation with low-energy shocks. When high-energy (360 J) shocks are to be used, transthoracic impedance appears to be of less importance.
本报告总结了心血管急症电疗法的进展。强调了提供确定性治疗的紧迫性，并评估了自动体内和体外除颤器、实用体外起搏以及心脏复律和除颤的机械技术的作用。除了永久植入起搏器的患者外，推荐电极板的标准位置。对于这些患者，除颤电极应距离起搏器发生器至少5英寸。回顾了心室颤动除颤的能量需求，得出的结论是初始除颤电击应为200焦耳。胸壁阻抗的决定因素很重要，特别是在使用低能量电击时，因为高胸壁阻抗会导致低能量电击除颤的成功率较低。当使用高能量（360焦耳）电击时，胸壁阻抗似乎不那么重要。
