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Article: Dose-response relationship for successful internal atrial defibrillation

TitleDose-response relationship for successful internal atrial defibrillation
Authors
Issue Date2003
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2003, v. 26 n. 5, p. 1249-1253 How to Cite?
AbstractThe dose-response relationship for successful defibrillation has been determined in man for the ventricle but not for the atrium. The purpose of this study was to determine the dose-response relationship for internal atrial defibrillation in humans. Seventy-seven consecutive patients underwent internal atrial defibrillation for acute (n = 14) or chronic AF (n = 63). Shocks were delivered in 40-V increments between electrodes positioned in the coronary sinus and the right atrium until successful conversion or a maximum of 400 V was reached. The shock strength versus success of shock data were subjected to a Kaplan-Meier survival analysis combined with a nonparametric probability analysis to arrive at the dose-response relationship. Using this relationship, comparisons were made between acute and chronic AF and clinical relevant conversion percentages (20, 50, 80 and 95%) were estimated and were compared with the conventional mean threshold. There were significant dose-response relationships in both patients groups (P < 0.05). The Kaplan-Meier analysis comparing patients with chronic and acute AF showed significant differences in their dose-response relationships (P < 0.001). The estimated shock intensity for 95% conversion in patients with acute and chronic AF was 279 V (2.9 J) and 433 V (6.6 J), respectively (P < 0.001). The conventional mean defibrillation threshold in patients with acute (192 ± 15 V. 1.4 ± 0.2 J) and chronic AF (343 ± 8 V, 4.4 ± 0.2 J) predicted the 60% and 45% chance of successful conversion, respectively. In conclusion, this study demonstrates that single shock conversion data can be used to determine a dose-response relationship, which can be used to estimate the shock intensity required for specific successful atrial defibrillation efficacy and to compare different clinical factors that affect defibrillation efficacy.
Persistent Identifierhttp://hdl.handle.net/10722/78050
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorAyers, GMen_HK
dc.date.accessioned2010-09-06T07:38:37Z-
dc.date.available2010-09-06T07:38:37Z-
dc.date.issued2003en_HK
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2003, v. 26 n. 5, p. 1249-1253en_HK
dc.identifier.issn0147-8389en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78050-
dc.description.abstractThe dose-response relationship for successful defibrillation has been determined in man for the ventricle but not for the atrium. The purpose of this study was to determine the dose-response relationship for internal atrial defibrillation in humans. Seventy-seven consecutive patients underwent internal atrial defibrillation for acute (n = 14) or chronic AF (n = 63). Shocks were delivered in 40-V increments between electrodes positioned in the coronary sinus and the right atrium until successful conversion or a maximum of 400 V was reached. The shock strength versus success of shock data were subjected to a Kaplan-Meier survival analysis combined with a nonparametric probability analysis to arrive at the dose-response relationship. Using this relationship, comparisons were made between acute and chronic AF and clinical relevant conversion percentages (20, 50, 80 and 95%) were estimated and were compared with the conventional mean threshold. There were significant dose-response relationships in both patients groups (P < 0.05). The Kaplan-Meier analysis comparing patients with chronic and acute AF showed significant differences in their dose-response relationships (P < 0.001). The estimated shock intensity for 95% conversion in patients with acute and chronic AF was 279 V (2.9 J) and 433 V (6.6 J), respectively (P < 0.001). The conventional mean defibrillation threshold in patients with acute (192 ± 15 V. 1.4 ± 0.2 J) and chronic AF (343 ± 8 V, 4.4 ± 0.2 J) predicted the 60% and 45% chance of successful conversion, respectively. In conclusion, this study demonstrates that single shock conversion data can be used to determine a dose-response relationship, which can be used to estimate the shock intensity required for specific successful atrial defibrillation efficacy and to compare different clinical factors that affect defibrillation efficacy.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_HK
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAtrial Fibrillation - physiopathology - therapyen_HK
dc.subject.meshElectric Countershock - instrumentation - methodsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshStatistics, Nonparametricen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleDose-response relationship for successful internal atrial defibrillationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0147-8389&volume=26 &issue=5&spage=1249&epage=53&date=2003&atitle=Dose-response+Relationship+for+Successful+Internal+Atrial+Defibrillation.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1460-9592.2003.t01-1-00176.xen_HK
dc.identifier.pmid12765454-
dc.identifier.scopuseid_2-s2.0-0037728783en_HK
dc.identifier.hkuros81598en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037728783&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume26en_HK
dc.identifier.issue5en_HK
dc.identifier.spage1249en_HK
dc.identifier.epage1253en_HK
dc.identifier.isiWOS:000182801900011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridAyers, GM=7102015157en_HK

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