Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Left ventricular function after repeated episodes of ventricular fibrillation and defibrillation assessed by transoesophageal echocardiography
*Department of Thoracic Surgery, Karolinska Institute at Karolinska Hospital Stockholm, Sweden
Department of Cardiology, Karolinska Institute at Karolinska Hospital Stockholm, Sweden
Department of Thoracic Physiology, Karolinska Institute at Karolinska Hospital Stockholm, Sweden
Department of Thoracic Anesthesiology, Karolinska Institute at Karolinska Hospital Stockholm, Sweden
revised 28 February 1996; accepted 12 March 1996.
correspondence: Dr Mikaeal Runsiö. Department of Thoracic Surgery, Karolinska Hospital. S-171 76 Stockholm, Sweden
Abstract
Background Investigators studying the effects of cardioverter-defibrillators on left ventricular systolic function have given only minor attention to the diastolic effects.
Objectives The purpose of this study was to investigate the impact of repeated episodes of ventricular fibrillation and defibrillation on systolic function and diastolic filling of the left ventricle during non-thoracotomy implantation of a cardioverter-defibrillator.
Methods Systolic function and diastolic filling of the left ventricle were assessed peri-operatively on a beat-by-beat basis using a transoesophageal echo-Doppler technique in 12 patients during 
4 episodes of ventricular fibrillation and defibrillation. Systolic function was assessed from the fractional area change and diastolic filling from the E/A ratio. Arterial blood pressure and the ECG were recorded continuously.
Results Blood pressure and heart rate did not change significantly throughout the procedure. The systolic function, similarly, was not significantly affected; the only changes were seen in the first two beats after defibrillation when the mean fractional area increased from 0·2±0·01 to 0·4±0·02 and 0·3±0·02, respectively (P<0·001). Diastolic filling was, however, impaired as reflected by a decrease in the E/A ratio from 2·6±0·5 before to 1·6±0·4 (P<0·01) after repeated threshold tests.
Conclusions. While the combined ischaemic and electrical trauma caused by repeated episodes of ventricular fibrillation and defibrillation during the implantation of a cardioverter-defibrillator did not cause any systolic dysfunction, diastolic filling was significantly impaired.
Key Words: Arrhythmias • defibrillation • transoesophageal echocardiography
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. Goldenberg, A. J. Moss, W. J. Hall, S. McNitt, W. Zareba, M. L. Andrews, D. S. Cannom, and for the Multicenter Automatic Defibrillator Implan Causes and Consequences of Heart Failure After Prophylactic Implantation of a Defibrillator in the Multicenter Automatic Defibrillator Implantation Trial II Circulation, June 20, 2006; 113(24): 2810 - 2817. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bansch, D. Bocker, J.u. Brunn, M. Weber, G.u. Breithardt, and M. Block Clusters of ventricular tachycardias signify impaired survival in patients with idiopathic dilated cardiomyopathy and implantable cardioverter defibrillators J. Am. Coll. Cardiol., August 1, 2000; 36(2): 566 - 573. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. T. Leng, N. A. Paradis, H. Calkins, R. D. Berger, A. C. Lardo, K. C. Rent, and H. R. Halperin Resuscitation After Prolonged Ventricular Fibrillation With Use of Monophasic and Biphasic Waveform Pulses for External Defibrillation Circulation, June 27, 2000; 101(25): 2968 - 2974. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Hurst, M. Hinrichs, C. Breidenbach, N. Katz, and B. Waldecker Detection of myocardial injury during transvenous implantation of automatic cardioverter-defibrillators J. Am. Coll. Cardiol., August 1, 1999; 34(2): 402 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J P Bourke, R W F Campbell, J M McComb, S S Furniss, J C Doig, and C J Hilton Surgery for postinfarction ventricular tachycardia in the pre-implantable cardioverter defibrillator era: early and long term outcomes in 100 consecutive patients Heart, August 1, 1999; 82(2): 156 - 162. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Bourke, J. Gray, C. J. Hilton, S. S. Furniss, S. Khan, J. M. McComb, and R. W.F. Campbell Identifying patients at low risk of death from cardiac failure after operation for postinfarct ventricular tachycardia Ann. Thorac. Surg., February 1, 1999; 67(2): 404 - 410. [Abstract] [Full Text] [PDF]
|
|