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.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine