Burst stimulation improves hemodynamics during resuscitation after prolonged ventricular fibrillation

Academic Article

Abstract

  • Background-Although return of spontaneous circulation is frequently achieved during resuscitation for sudden cardiac arrest, systolic blood pressure can then decrease, requiring additional myocardial support. Previous studies have shown that a series of 1-ms electric pulses delivered through the defibrillation patches during ventricular fibrillation can stimulate the autonomic nervous system to increase myocardial function after defibrillation. We hypothesized that a similar series of electric pulses could increase myocardial function and blood pressure during the early postresuscitation period. Methods and Results-Six swine were studied that underwent 6 to 7 minutes of fibrillation. Each animal received 5, 10, 15, or 20 pulse packets consisting of six 10-A, 1-ms pulses every 3 to 4 s in random order whenever systolic blood pressure became <50 mm Hg. All 4 sets of pulse packets were delivered to each animal. Systolic blood pressure and cardiac function (left ventricular+dP/dt) were increased to above prestimulation levels or above by all 4 sets of pulse packets. The increases were significantly greater for the longer than the shorter number of pulse packets. The mean±SD duration of the time that the systolic pressure remained above 50 mm Hg after pulse delivery was 4.2±2.5 minutes. Conclusions-Electric stimulation during regular rhythm after prolonged ventricular fibrillation and resuscitation can increase blood pressure and cardiac function to above prestimulation levels. (Circ Arrhythmia Electrophysiol. 2009;2:57-62.) © 2009 American Heart Association, Inc.
  • Authors

    Digital Object Identifier (doi)

    Author List

  • Walcott G; Melnick S; Killingsworth C; Ideker R
  • Start Page

  • 57
  • End Page

  • 62
  • Volume

  • 2
  • Issue

  • 1