title: The effect of an unsuccessful subthreshold shock on the energy requirement for the subsequent defibrillation.
abstract: The effect of an unsuccessful subthreshold shock on the energy requirement for the subsequent defibrillation was studied in 10 anesthetized dogs. Defibrillation was achieved with a spring catheter electrode in the superior vena cava and a patch electrode on the anteroapical ventricular wall. Success rates of defibrillation 20 seconds from the onset of ventricular fibrillation were determined at three energy levels with and without a preceding subthreshold shock. Altogether, 637 episodes of fibrillation-defibrillation were performed (63.7 +/- 6.7 per dog). Predicted energy levels for defibrillation success rates of 50% and 80% (E50 and E80) acquired from a logistic regression curve were 0.0303 +/- 0.0064 and 0.0367 +/- 0.0069 joule/gm, respectively, without subthreshold shocks. E50 and E80 with an unsuccessful subthreshold shock resulted in comparable values (E50: 0.0325 +/- 0.0041 joule/gm; E80: 0.0.380 +/- 0.0100 joule/gm). Our results suggest that an unsuccessful low-energy shock does not alter the energy requirement for subsequent defibrillation with an implantable defibrillator.
authors.affiliation: Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD 21205.
authors.forename: Y
authors.initials: Y
authors.lastname: Murakawa
authors.forename: B E
authors.initials: BE
authors.lastname: Gliner
authors.forename: B
authors.initials: B
authors.lastname: Shankar
authors.forename: N V
authors.initials: NV
authors.lastname: Thakor
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D004554:Electric Countershock / Q000379:methods*; D004560:Electricity; D019736:Prostheses and Implants; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy