0
September 28, 1979, Vol 242, No. 13 >
ARTICLE | September 28, 1979

Energy Levels and Patient Weight in Ventricular Defibrillation FREE

Joseph A. Gascho, MD; Richard S. Crampton, MD; James N. Sipes, MD; Michael L. Cherwek, MD; Frank P. Hunter, BEE; William M. O'Brien, MD
[+] Author Affiliations

Read in part before the 28th annual scientific session of the American College of Cardiology, Miami Beach, March 14, 1979.

Reprint requests to Box 158, Medical Center, University of Virginia, Charlottesville, VA 22908 (Dr Crampton).


JAMA. 1979;242(13):1380-1384. doi:10.1001/jama.1979.03300130024013
Text Size: A A A
Published online
Article
References

In a prospective survey employing conventional devices that stored 400 joules or less, direct-current shocks that delivered 194±11 joules (1.8 joules/kg) to the chest wall terminated 45 of 46 episodes of ventricular fibrillation in 11 of 12 patients weighing 91 to 225 kg. Patients with coronary disease defibrillated more easily than patients without coronary disease. Weight did not determine outcome. The 98% defibrillation efficiency occurred at only half the energy predicted for 50% efficiency from retrospective data. Human defibrillation not only occurred at one third the untested level recommended by proponents of high-energy defibrillation, but also at one fourth the energy, defibrillating 69% of comparably heavy animals. Thus, the costly defibrillators delivering 400 to 800 joules now sold by 11 of 14 American manufacturers are superfluous, untested, potentially lethal devices with which to attempt ventricular defibrillation.

(JAMA 242:1380-1384, 1979).

REFERENCES

1 +
Geddes LA, Tacker WA, Rosborough JP, et al:  Electrical dose for ventricular defibrillation of large and small animals using precordial electrodes . J Clin Invest 53:310-319, 1974;.
2 +
Gold JH, Schuder JC, Stoeckle H, et al:  Transthoracic ventricular defibrillation in the 100 kg calf with unidirectional rectangular pulses . Circulation 56:745-750, 1977;.
3 +
Tacker WA Jr, Galioto FM Jr, Guiliani E, et al:  Energy dosage for human transchest electrical ventricular defibrillation . N Engl J Med 290:214-215, 1974;.
4 +
Collins RE, Guiliani ER, Tacker WA, et al:  Transthoracic ventricular defibrillation: Success and body weight . Med Instrum 12:53, 1978;.
5 +
Geddes LA, Bourland JD, Coulter TW, et al:  A megawatt defibrillator for transchest defibrillation of heavy subjects . Med Biol Eng 11:747-754, 1973;.
6 +
Curry JJ, Quintana FJ:  Myocardial infarction with ventricular fibrillation during pregnancy treated by direct current defibrillation with fetal survival . Chest 58:82-84, 1970;.
7 +
Lappin HA:  Ventricular defibrillators in heavy patients . N Engl J Med 291:153, 1975;.
8 +
Tacker WA, Morris GC, Winters WL:  Transchest ventricular defibrillation of a subject weighing 102.5 kg (225.9 lb) . South Med J 68:786-788, 1975;.
9 +
Anderson GJ, Suelzer J:  The efficacy of trapezoidal wave forms for ventricular defibrillation . Chest 70:298-300, 1976;.
10 +
Campbell NPS, Webb SW, Adgey AAJ, et al:  Transthoracic ventricular defibrillation in adults . Br Med J 2:1379-1381, 1977;.
11 +
De Silva RA, Lown B:  Energy requirement for defibrillation of a markedly overweight patient . Circulation 57:827-830, 1978;.
12 +
Crampton RS, Gascho JA, Cherwek ML, et al:  Low-energy and fast serial dc shock ventricular defibrillation in man . Med Instrum 12:53, 1978;.
13 +
Kong TQ, Proudfit WL:  Repeated direct current countershock without myocardial injury . JAMA 187:60-61, 1964;.
14 +
Marriott HJL, Sandler AI:  Multiple countershocks . N Engl J Med 270:1019, 1964;.
15 +
Lown B, Crampton RS, De Silva RA, et al:  The energy for ventricular defibrillation—too little or too much? N Engl J Med 298:1252-1253, 1978;.
16 +
American Heart Association, National Academy of Sciences—National Research Council:  Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) . JAMA 227( (suppl) ):833-867, 1974;.
17 +
Collins RE, Guiliani ER, Tacker WA Jr, et al:  Transthoracic ventricular defibrillation: Success and body weight . Med Instrum 12:53, 1978;.
18 +
Wiggers CJ:  The physiologic basis for cardiac resuscitation from ventricular fibrillation—method for serial defibrillation . Am Heart J 20:413-423, 1940;.
19 +
Geddes LA, Tacker WA, Rosborough J, et al:  The increased efficacy of high energy defibrillation . Med Biol Eng 14:330-333, 1976;.
20 +
Zipes DP, Fischer J, King RM, et al:  Termination of ventricular fibrillation in dogs by depolarizing a critical amount of myocardium . Am J Cardiol 36:37-44, 1975;.
21 +
Nicholas WC, Hodgson JL, Kline DE, et al:  Performance characteristics of three commercial defibrillators in transthoracic ventricular defibrillation of sheep, dogs, and calves . Med Instrum 12:12-16, 1978;.
22 +
Gascho J, Sipes J, Cherwek M, et al:  Determinants of ventricular defibrillation . Circulation 58( (suppl 2) ):203, 1978;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Geddes LA, Tacker WA, Rosborough JP, et al:  Electrical dose for ventricular defibrillation of large and small animals using precordial electrodes . J Clin Invest 53:310-319, 1974;.
2 +
Gold JH, Schuder JC, Stoeckle H, et al:  Transthoracic ventricular defibrillation in the 100 kg calf with unidirectional rectangular pulses . Circulation 56:745-750, 1977;.
3 +
Tacker WA Jr, Galioto FM Jr, Guiliani E, et al:  Energy dosage for human transchest electrical ventricular defibrillation . N Engl J Med 290:214-215, 1974;.
4 +
Collins RE, Guiliani ER, Tacker WA, et al:  Transthoracic ventricular defibrillation: Success and body weight . Med Instrum 12:53, 1978;.
5 +
Geddes LA, Bourland JD, Coulter TW, et al:  A megawatt defibrillator for transchest defibrillation of heavy subjects . Med Biol Eng 11:747-754, 1973;.
6 +
Curry JJ, Quintana FJ:  Myocardial infarction with ventricular fibrillation during pregnancy treated by direct current defibrillation with fetal survival . Chest 58:82-84, 1970;.
7 +
Lappin HA:  Ventricular defibrillators in heavy patients . N Engl J Med 291:153, 1975;.
8 +
Tacker WA, Morris GC, Winters WL:  Transchest ventricular defibrillation of a subject weighing 102.5 kg (225.9 lb) . South Med J 68:786-788, 1975;.
9 +
Anderson GJ, Suelzer J:  The efficacy of trapezoidal wave forms for ventricular defibrillation . Chest 70:298-300, 1976;.
10 +
Campbell NPS, Webb SW, Adgey AAJ, et al:  Transthoracic ventricular defibrillation in adults . Br Med J 2:1379-1381, 1977;.
11 +
De Silva RA, Lown B:  Energy requirement for defibrillation of a markedly overweight patient . Circulation 57:827-830, 1978;.
12 +
Crampton RS, Gascho JA, Cherwek ML, et al:  Low-energy and fast serial dc shock ventricular defibrillation in man . Med Instrum 12:53, 1978;.
13 +
Kong TQ, Proudfit WL:  Repeated direct current countershock without myocardial injury . JAMA 187:60-61, 1964;.
14 +
Marriott HJL, Sandler AI:  Multiple countershocks . N Engl J Med 270:1019, 1964;.
15 +
Lown B, Crampton RS, De Silva RA, et al:  The energy for ventricular defibrillation—too little or too much? N Engl J Med 298:1252-1253, 1978;.
16 +
American Heart Association, National Academy of Sciences—National Research Council:  Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) . JAMA 227( (suppl) ):833-867, 1974;.
17 +
Collins RE, Guiliani ER, Tacker WA Jr, et al:  Transthoracic ventricular defibrillation: Success and body weight . Med Instrum 12:53, 1978;.
18 +
Wiggers CJ:  The physiologic basis for cardiac resuscitation from ventricular fibrillation—method for serial defibrillation . Am Heart J 20:413-423, 1940;.
19 +
Geddes LA, Tacker WA, Rosborough J, et al:  The increased efficacy of high energy defibrillation . Med Biol Eng 14:330-333, 1976;.
20 +
Zipes DP, Fischer J, King RM, et al:  Termination of ventricular fibrillation in dogs by depolarizing a critical amount of myocardium . Am J Cardiol 36:37-44, 1975;.
21 +
Nicholas WC, Hodgson JL, Kline DE, et al:  Performance characteristics of three commercial defibrillators in transthoracic ventricular defibrillation of sheep, dogs, and calves . Med Instrum 12:12-16, 1978;.
22 +
Gascho J, Sipes J, Cherwek M, et al:  Determinants of ventricular defibrillation . Circulation 58( (suppl 2) ):203, 1978;.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems