[Optimisation of electroimpulse therapy of life threatening arrhythmia in patients with ischemic heart disease].
The thorax impedance (TI) was measured in 230 patients with atrial and ventricular rhythm impairments according to L. Geddes et al. Gauze napkins moistened in physiological solution (PS) and in 7% hypertonic solution NaCl (HS) were used as contact material. The electrode diameter was approx. 12 cm. The use of HS was shown to bring about a TI decrease by 21% (from 77.0 +/- 0.9 to 61.0 +/- 1.0 ohm) versus the former. A high TI (60-146 ohm) was registered in 41 of 230 patients for whom PS was applied. HS ensures a TI decrease by 17% (to 79-128 ohm). Forty-six patients with atrial fibrillation underwent the electropulse therapy (EPT). Low-energy bipolar discharges (< or = 65 J.) were effective in 31 (67.5%) of 46 patients, < or = 65 J. Discharges were more effective in patients with TI < or = 60 ohm versus patients with TI > 60 ohm (76.7 and 52%, respectively, p = 0.04). With HS the efficiency of bipolar < or = 90 J. discharges reached 83% (38/46). According to estimates, at least one more 100-115 J. discharge would be needed for 7 patients to ensure the similar EPT efficiency with PS.
Razumov
K V
KV
Vostrikov
V A
VA
Kholin
P V
PV
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D002307:Cardiography, Impedance; D004554:Electric Countershock; D017097:Electric Impedance; D004566:Electrodes; D006801:Humans; D017202:Myocardial Ischemia / Q000150:complications*; D012462:Saline Solution, Hypertonic; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D012462:Saline Solution, Hypertonic