Blood pressure and heart rate immediately after termination of short-term ventricular fibrillation. 2008

J D Schipke, and G Heusch, and A Fritzsche, and K Meyer, and E Gams, and J Winter
Research Group Experimental Surgery, Department of Surgery I, University Hospital Duesseldorf, Germany. schipke@med.uni-duesseldorf.de

BACKGROUND Implantable cardioverter/defibrillators (ICDs) can detect ventricular fibrillation (VF) and terminate it. For determining the optimal defibrillation threshold, ventricular fibrillation is repetitively induced and terminated with DC shocks. Depending on the protocol, several fibrillation/defibrillation sequences are mandatory before the final implantation of an ICD. This procedure provides an elegant human model of circulatory arrest and resuscitation. METHODS In anesthetized 73 patients (15 females) of on the average 60+/-11 years, the end-expiratory pressure was set to zero. Left ventricular pressure (LVP) was monitored with a microtip-catheter, central venous pressure (CVP) through a cannula which was advanced into the superior V. cava. ECG was recorded. After testing, a monoexponential function was found to best fit the time courses of LVP, CVP and heart rate. Data are mean+/-S.D. RESULTS After termination of circulatory arrest, peak LVP increased with a time constant tau of 9.2+/-4.2 beats, CVP decreased with tau=2.8+/-1.5 beats, and RR-intervals decreased with tau=4.3+/-3.5 beats. Correlations between prefibrillatory values and steady-state values after termination of fibrillation were high: peak LVP: r=0.78; CVP: r=0.95; RRI: r=0.82. CONCLUSIONS After DC termination of VF, the heart 'finds' relatively quickly a steady-state rhythm at the prefibrillatory level (22 beats), thereby normalizing CVP almost in parallel (14 beats). Peak LVP plateaus only after about 40 beats, although reasonable arterial pressures are reached within the first beats. Our data are limited to periods of ventricular fibrillation of no longer than 60s, which limits the generalisability to the setting of clinical cardiac arrest.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002496 Central Venous Pressure The blood pressure in the central large VEINS of the body. It is distinguished from peripheral venous pressure which occurs in an extremity. Venous Pressure, Central,Central Venous Pressures,Pressure, Central Venous,Pressures, Central Venous,Venous Pressures, Central
D004554 Electric Countershock An electrical current applied to the HEART to terminate a CARDIAC ARRHYTHMIA. Cardiac Electroversion,Cardioversion,Defibrillation, Electric,Electroversion, Cardiac,Electrical Cardioversion,Electroversion Therapy,Therapy, Electroversion,Cardiac Electroversions,Cardioversion, Electrical,Cardioversions,Cardioversions, Electrical,Countershock, Electric,Countershocks, Electric,Defibrillations, Electric,Electric Countershocks,Electric Defibrillation,Electric Defibrillations,Electrical Cardioversions,Electroversion Therapies,Electroversions, Cardiac,Therapies, Electroversion
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D005260 Female Females
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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