title: Medium voltage therapy for preventing and treating asystole and PEA in ICDs.
abstract: BACKGROUND
  Sudden cardiac death (SCD) takes up to 500,000 lives each year before a victim can even be treated. To address this the implantable cardioverter defibrillator (ICD) was developed to treat those identified at high risk of SCD. Unfortunately, there are a significant number of cases in which the ICD does not successfully return a victim to normal rhythm and effective perfusion of the blood.
  
  
  METHODS
  The vast majority of cases that are not responsive to the ICD therapy require cardio-pulmonary resuscitation (CPR) according to current resuscitation guidelines. A novel electrical stimulus called medium voltage therapy (MVT) has shown efficacy in producing coronary and carotid blood flow during ventricular fibrillation. This report presents the case that the same stimulus may be effective and feasible for use in ICD patients that do not respond to their ICD therapy, or do not have a rhythm in which, an ICD shock is indicated.
  
  
  CONCLUSIONS
  The inclusion of MVT technology in implantable devices may be effective in preparing the heart for successful defibrillation or in improving the metabolic condition of the heart to the extent that a pulsatile rhythm may spontaneously develop.
authors: Byron L
authors: BL
authors: Gilman
authors: James E
authors: JE
authors: Brewer
authors: Kai
authors: K
authors: Kroll
authors: Mark W
authors: MW
authors: Kroll
mesh_terms: D001145:Arrhythmias, Cardiac / Q000628:therapy; D016275:Atrial Function; D001794:Blood Pressure / Q000502:physiology; D016887:Cardiopulmonary Resuscitation; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004599:Electric Stimulation Therapy / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans