Prolonged burst as a new method for cardioverter-defibrillator testing
| Autor: | Jan Lukl, Milos Taborsky, Jana Zapletalová, Alan Bulava, Petr Schneiderka, Marián Fedorco, Dan Marek |
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| Rok vydání: | 2012 |
| Předmět: |
Male
business.industry Sedation Enolase Electric Countershock Pain management Middle Aged medicine.disease Group B Defibrillators Implantable Equipment Failure Analysis Physiology (medical) Shock (circulatory) Anesthesia Ventricular fibrillation Ventricular Fibrillation Medicine Humans General anaesthesia Female medicine.symptom Cardiology and Cardiovascular Medicine business Electrophysiologic Techniques Cardiac Aged |
| Zdroj: | Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 15(1) |
| ISSN: | 1532-2092 |
| Popis: | Aim To find out whether it is possible to anaesthetize patients safely without analgesia and sedation, using burst pacing prolonged until the patient becomes unconscious. Methods One hundred and four patients undergoing implantation or reimplantation of a cardioverter-defibrillator were included. Patients randomized into Group B underwent prolonged burst pacing without analgesia and sedation. Patients in Group T underwent a T-wave shock under analgesia and sedation. Blood samples for measurement of serum neuron-specific enolase were taken before surgery and 6, 24, and 48 h after the procedure. Results From the 104 patients, 51 were randomly assigned to Group B and 53 to Group T. Four patients from Group B were switched to Group T (ventricular fibrillation not induced by burst pacing). The clinical characteristics of both groups were similar. The mean total time of cardiac arrest was significantly longer in Group B (23.0 ± 4.4 s, median 22.7) vs. Group T (10.3 ± 3.0 s, median 10.0), P < 0.0001 (Mann–Whitney U-test). The effectiveness of both induction methods was similar (92.1% in Group B and 100% in Group T). The mean neuron-specific enolase levels after 6, 24, and 48 h were similar in Groups B and T (13.1 ± 6.3 and 11.6 ± 5.8 mg/L, 14.5 ± 7.5 and 13.4 ± 6.0 mg/L, and 14.9 ± 5.9 and 12.2 ± 6.0 mg/L, respectively) as were these levels compared with baseline neuron-specificenolase levels (14.0 ± 5.9 and 13.4 ± 4.0 mg/L, respectively), P = NS for all. Conclusion Despite a longer time of total cardiac arrest, prolonged burst pacing appears to be a safe and effective method for induction of ventricular fibrillation during cardioverter-defibrillator testing, which enables omission of analgesia and sedation or general anaesthesia. |
| Databáze: | OpenAIRE |
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