Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Cardiac injury with damped sine and trapezoidal defibrillator waveforms
*Regional Medical Cardiology Centre, Royal Victoria Hospital Belfast, N. Ireland
University of Ulster, Jordanstown Belfast, N. Ireland
Department of Physiology, Queen's University Belfast, N. Ireland
Received 2 November 1988; revised 3 January 1989; .
Correspondence to: A. A. J. Adgey MD FRCP, Consultant Cardiologist, Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland
Abstract
To assess defibrillator-induced cardiac damage, 49 anaesthetized greyhounds received either no shocks (control group) or five shocks from a defibrillator delivering one of five waveforms (Lown, Edmark, Belfast damped sine waveforms: 5 and 20 ms trapezoidal waveforms). At 3 days the hearts of the 36 surviving dogs were examined for macroscopic damage.
The Belfast and Edmark waveforms caused significantly more damage (mean 21·1 ± SEM 2·9 g and 16·0 ± 3·7 g) respectively than the Lown waveform (3·5 ±1·3 g) P<0·01. The 20 ms trapezoid caused significantly more damage (8·1 ± 3·1 g) than the 5 ms pulse (0·7 ±0·3 g) (P< 0·05).
The ventricular ectopic counts per minute were not significantly different in the three sine wave and 20 ms trapezoidal groups at 24 and 48 h (P> 0·05), but at 2 and 72 h were significantly greater in the Belfast and Edmark groups than in the Lown group (2 h, Belfast P < 0·01, Edmark P < 005: 72 hP< 0·05).
At 15 min there was more right chest ST-segment elevation in the Belfast than in the Lown, Edmark and 20 ms trapezoid groups (P<0·01), while left chest ST elevation was greater in the Belfast and Edmark than in the Lown (P < 0·05) and 20 ms trapezoid groups (P < 0·01).
In this model, the Belfast and Edmark waveforms had higher peak currents (57·7± 1·8 and 67·6±1·5 A) and delivered energies (268·8 ± 3·4 and 276·8 + 4·4 J) than the Lown waveform (55±1·3 A, 24612±617 J). This factor as well as differences in waveform configuration may account for the differences between the groups.
Key Words: Sine wave and trapezoidal defibrillators • myocardial necrosis • ST-segment elevation • entricular arrhythmias
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