Utility of the Ventricular Fibrillation Waveform to Predict a Return of Spontaneous Circulation and Distinguish Acute From Post Myocardial Infarction or Normal Swine in Ventricular Fibrillation Cardiac Arrest
| Autor: | Karl B. Kern, Christian Dameff, Julia H. Indik, Daniel Allen, Ronald W. Hilwig, Michael Gura |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Swine Defibrillation medicine.medical_treatment Myocardial Infarction Return of spontaneous circulation Diagnosis Differential Electrocardiography Predictive Value of Tests Physiology (medical) Internal medicine Occlusion medicine Animals Myocardial infarction Cardiopulmonary resuscitation business.industry Recovery of Function medicine.disease Cardiopulmonary Resuscitation Heart Arrest Disease Models Animal medicine.anatomical_structure Shock (circulatory) Anesthesia Blood Circulation Ventricular Fibrillation Ventricular fibrillation Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Circulation: Arrhythmia and Electrophysiology. 4:337-343 |
| ISSN: | 1941-3084 1941-3149 |
| DOI: | 10.1161/circep.110.960419 |
| Popis: | Background— In cardiac arrest, the ventricular fibrillation (VF) waveform, particularly amplitude spectral area (AMSA) and slope, predicts the return of spontaneous circulation (ROSC), but it is unknown whether the predictive utility differs in an acute myocardial infarction (MI), prior MI, or normal myocardium and if the waveform can distinguish the underlying myocardial state. We hypothesized that in a swine model of VF cardiac arrest, AMSA and slope predict ROSC after a shock independent of substrate and distinguish an acute from nonacute MI state. Methods and Results— MI was induced by occlusion of the left anterior descending artery. Post MI swine recovered for a 2-week period before induction of VF. VF was untreated for 8 minutes in 10 acute MI, 10 post MI, and 10 control swine. AMSA and slope predicted ROSC after a shock independent of myocardial state. For AMSA >31 mV-Hz, the odds ratio was 62 ( P ≤0.001) compared with AMSA 3.1 mV/s, odds ratio was 52 ( P ≤0.001) compared with slope 33.5 mV-Hz, the sensitivity to identify an acute from nonacute (control or post MI) state was 83%. Conclusions— In a swine model of VF cardiac arrest, AMSA and slope predict ROSC independent of myocardial substrate. Furthermore, with chest compressions, the VF waveform evolves differently and may offer a means to distinguish an acute MI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|