TY - JOUR
T1 - Automatic defibrillation in man
T2 - Is it feasible?
AU - Watkins, Levi
AU - Reid, Philip R.
AU - Platia, Edward V.
AU - Mower, Morton Maimon
AU - Griffith, Lawrence S.C.
AU - Mirowski, Michel
PY - 1983/6
Y1 - 1983/6
N2 - Twenty-eight patients who survived multiple arrhythmic cardiac arrest refractory to medical therapy underwent implantation of the automatic defibrillator without additional antiarrhythmic surgery. Lateral thoracotomy was used for implantation in 14 patients and the subxiphoid technique was used in 14. There was no operative mortality and surgical complications were minimal. The longest follow-up was 29 months and the average was 14 months. The implanted device correctly identified and reverted 50 episodes of spontaneous malignant ventricular tachyarrhytthmias in six hospitalized patients. After discharge, 20 episodes of automatic out-of-hospital resuscitations occurred in eight patients. Kaplan-Meier survival curves, based on the assumption that out-of-hospital defibrillations would otherwise have been lethal, indicated an expected 1 year mortality of 60 percent. Seven deaths were in fact observed in this period for an actual mortality rate of 30 percent. We conclude that automatic defibrillation is clearly feasible in man and appears to increase survival in selected high-risk patients.
AB - Twenty-eight patients who survived multiple arrhythmic cardiac arrest refractory to medical therapy underwent implantation of the automatic defibrillator without additional antiarrhythmic surgery. Lateral thoracotomy was used for implantation in 14 patients and the subxiphoid technique was used in 14. There was no operative mortality and surgical complications were minimal. The longest follow-up was 29 months and the average was 14 months. The implanted device correctly identified and reverted 50 episodes of spontaneous malignant ventricular tachyarrhytthmias in six hospitalized patients. After discharge, 20 episodes of automatic out-of-hospital resuscitations occurred in eight patients. Kaplan-Meier survival curves, based on the assumption that out-of-hospital defibrillations would otherwise have been lethal, indicated an expected 1 year mortality of 60 percent. Seven deaths were in fact observed in this period for an actual mortality rate of 30 percent. We conclude that automatic defibrillation is clearly feasible in man and appears to increase survival in selected high-risk patients.
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U2 - 10.1016/0002-9610(83)90133-2
DO - 10.1016/0002-9610(83)90133-2
M3 - Article
C2 - 6859412
AN - SCOPUS:0020616927
SN - 0002-9610
VL - 145
SP - 752
EP - 755
JO - The American Journal of Surgery
JF - The American Journal of Surgery
IS - 6
ER -