Kuelz K W, Hsia P W, Wise R M, Mahmud R, Damiano R J
Medical College of Virginia, Richmond 23298.
IEEE Trans Biomed Eng. 1994 Aug;41(8):782-91. doi: 10.1109/10.310093.
Previous work has suggested that at higher absolute ventricular fibrillation voltages (AVFV), the heart is more amenable to defibrillation. This study investigated in a canine model whether voltage integration of the AVFV is associated with the defibrillation success rate. The moving-average filter was used to process the ventricular fibrillation (VF) waveform recorded from Lead II of the electrocardiogram (ECG). In seven animals, defibrillation trials were analyzed using a dc shock (DCS) successful approximately 50% of the time when delivered randomly. For each of a total of 84 DCS (40% successes, 60% failures), the fibrillation waveform just prior to DCS was analyzed. The integration of the AVFV waveform was performed over various sample sizes including 1, 4, 8, 16, 64, and 128 ms, as well as the time equal to the mean VF cycle length. The results suggest that dc shocks delivered at instants of higher values of integrated AVFV over the various window sizes are associated with successful defibrillation. Window sizes less than 16 ms appeared to offer the best discrimination. The integration of AVFV over the entire VF cycle length was significantly higher for successful rather than unsuccessful DCS. This interesting observation is consistent with the clinical observation that "coarse" VF (high AVFV) is easier to defibrillate than "fine" VF (low AVFV). The use of voltage integration of AVFV may have potential implications in the improvement of defibrillation success in implantable devices.
先前的研究表明，在较高的绝对室颤电压（AVFV）下，心脏更易于除颤。本研究在犬类模型中调查了AVFV的电压积分是否与除颤成功率相关。使用移动平均滤波器处理从心电图（ECG）的II导联记录的室颤（VF）波形。在七只动物中，对除颤试验进行了分析，使用直流电击（DCS），随机发放时成功率约为50%。对于总共84次DCS（40%成功，60%失败）中的每一次，分析DCS之前的颤动波形。在包括1、4、8、16、64和128毫秒以及等于平均VF周期长度的时间等各种样本大小上进行AVFV波形的积分。结果表明，在各种窗口大小上，在积分AVFV值较高的瞬间发放的直流电击与成功除颤相关。小于16毫秒的窗口大小似乎提供了最佳的辨别能力。成功的DCS与不成功的DCS相比，在整个VF周期长度上AVFV的积分显著更高。这一有趣的观察结果与临床观察一致，即“粗”VF（高AVFV）比“细”VF（低AVFV）更容易除颤。AVFV电压积分的应用可能对提高植入式设备的除颤成功率具有潜在意义。
