Amplitude spectral area of ventricular fibrillation and defibrillation success at low energy in out-of-hospital cardiac arrest.
AMSA
Cardiac arrest
Defibrillation
Ventricular fibrillation
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
26
04
2023
accepted:
25
07
2023
medline:
10
11
2023
pubmed:
9
8
2023
entrez:
9
8
2023
Statut:
ppublish
Résumé
The optimal energy for defibrillation has not yet been identified and very often the maximum energy is delivered. We sought to assess whether amplitude spectral area (AMSA) of ventricular fibrillation (VF) could predict low energy level defibrillation success in out-of-hospital cardiac arrest (OHCA) patients. This is a multicentre international study based on retrospective analysis of prospectively collected data. We included all OHCAs with at least one manual defibrillation. AMSA values were calculated by analyzing the data collected by the monitors/defibrillators used in the field (Corpuls 3 and Lifepak 12/15) and using a 2-s-pre-shock electrocardiogram interval. We run two different analyses dividing the shocks into three tertiles (T1, T2, T3) based on AMSA values. 629 OHCAs were included and 2095 shocks delivered (energy ranging from 100 to 360 J; median 200 J). Both in the "extremes analysis" and in the "by site analysis", the AMSA values of the effective shocks at low energy were significantly higher than those at high energy (p = 0.01). The likelihood of shock success increased significantly from the lowest to the highest tertile. After correction for age, call to shock time, use of mechanical CPR, presence of bystander CPR, sex and energy level, high AMSA value was directly associated with the probability of shock success [T2 vs T1 OR 3.8 (95% CI 2.5-6) p < 0.001; T3 vs T1 OR 12.7 (95% CI 8.2-19.2), p < 0.001]. AMSA values are associated with the probability of low-energy shock success so that they could guide energy optimization in shockable cardiac arrest patients.
Identifiants
pubmed: 37556074
doi: 10.1007/s11739-023-03386-6
pii: 10.1007/s11739-023-03386-6
doi:
Substances chimiques
Amsacrine
00DPD30SOY
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2397-2405Informations de copyright
© 2023. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).
Références
Orton RH (1954) Electrical defibrillation of the heart. Med J Aust 41(1–9):331. https://doi.org/10.5694/j.1326-5377.1954.tb85371.x
doi: 10.5694/j.1326-5377.1954.tb85371.x
pubmed: 13153560
Eisenberg MS, Copass MK, Hallstrom AP, Blake B, Bergner L, Short FACL (1980) Treatment of out-of-hospital cardiac arrests with rapid defibrillation by emergency medical technicians. N Engl J Med 302(25):1379–1383
doi: 10.1056/NEJM198006193022502
pubmed: 7374695
Zhou X, Daubert JP, Wolf PD, Smith WM, Ideker RE (1993) Epicardial mapping of ventricular defibrillation with monophasic and biphasic shocks in dogs. Circ Res 72(1):145–160. https://doi.org/10.1161/01.res.72.1.145
Cummins R, Ornato JP, Thies WH et al (1991) Improving survival from sudden cardiac arrest: the “Chain of Survival” concept of survival. Circulation 83:1832–1847
doi: 10.1161/01.CIR.83.5.1832
pubmed: 2022039
Martens PR, Russell JK, Wolcke B et al (2001) Optimal response to cardiac arrest study: defibrillation waveform effects. Resuscitation 49(3):233–243. https://doi.org/10.1016/S0300-9572(01)00321-5
doi: 10.1016/S0300-9572(01)00321-5
pubmed: 11719116
Kajino K, Iwami T, Berg RA et al (2009) Comparison of neurological outcomes following witnessed out-of-hospital ventricular fibrillation defibrillated with either biphasic or monophasic automated external defibrillators. Emerg Med J 26(7):492–496. https://doi.org/10.1136/EMJ.2008.059865
doi: 10.1136/EMJ.2008.059865
pubmed: 19546269
ECC Committee, Subcommittees and Task Forces of the American Heart Association (2005) American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 13;112(24 Suppl):IV1-203. https://doi.org/10.1161/CIRCULATIONAHA.105.166550
Stiell IG, Walker RG, Nesbitt LP et al (2007) BIPHASIC trial: a randomized comparison of fixed lower versus escalating higher energy levels for defibrillation in out-of-hospital cardiac arrest. Circulation 115(12):1511–1517. https://doi.org/10.1161/CIRCULATIONAHA.106.648204
doi: 10.1161/CIRCULATIONAHA.106.648204
pubmed: 17353443
Panchal AR, Bartos JA, Cabañas JG et al (2020) Part 3: adult basic and advanced life support: 2020 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. https://doi.org/10.1161/CIR.0000000000000916
doi: 10.1161/CIR.0000000000000916
pubmed: 33081530
pmcid: 7302067
Soar J, Böttiger BW, Carli P et al (2021) European resuscitation council guidelines 2021: adult advanced life support. Resuscitation 161:115–151. https://doi.org/10.1016/j.resuscitation.2021.02.010
doi: 10.1016/j.resuscitation.2021.02.010
pubmed: 33773825
Walcott GP, Killingsworth CR, Ideker RE (2003) Do clinically relevant transthoracic defibrillation energies cause myocardial damage and dysfunction? Resuscitation 59(1):59–70. https://doi.org/10.1016/S0300-9572(03)00161-8
doi: 10.1016/S0300-9572(03)00161-8
pubmed: 14580735
Doherty PW, McLaughlin PR, Billingham M, Kernoff R, Goris ML, Harrison DC (1979) Cardiac damage produced by direct current countershock applied to the heart. Am J Cardiol 43(2):225–232. https://doi.org/10.1016/S0002-9149(79)80008-9
doi: 10.1016/S0002-9149(79)80008-9
pubmed: 760477
Gazmuri RJ (2000) Effects of repetitive electrical shocks on postresuscitation myocardial function. Crit Care Med. https://doi.org/10.1097/00003246-200011001-00016
doi: 10.1097/00003246-200011001-00016
pubmed: 11098954
Tang W, Weil MH, Sun S et al (1999) The effects of biphasic and conventional monophasic defibrillation on postresuscitation myocardial function. J Am Coll Cardiol 34(3):815–822. https://doi.org/10.1016/S0735-1097(99)00270-3
doi: 10.1016/S0735-1097(99)00270-3
pubmed: 10483965
Xie J, Weil MH, Sun S et al (1997) High-energy defibrillation increases the severity of postresuscitation myocardial dysfunction. Circulation 96(2):683–688. https://doi.org/10.1161/01.CIR.96.2.683
doi: 10.1161/01.CIR.96.2.683
pubmed: 9244243
Sandroni C, Sanna T, Cavallaro F, Caricato A (2008) Myocardial stunning after successful defibrillation. Resuscitation 76(1):3–4. https://doi.org/10.1016/j.resuscitation.2007.06.020
doi: 10.1016/j.resuscitation.2007.06.020
pubmed: 17698278
Yamaguchi H, Weil MH, Tang W, Kamohara T, Jin X, Bisera J (2002) Myocardial dysfunction after electrical defibrillation. Resuscitation 54(3):289–296. https://doi.org/10.1016/S0300-9572(02)00149-1
doi: 10.1016/S0300-9572(02)00149-1
pubmed: 12204463
Tang W, Weil MH, Sun S (2000) Low-energy biphasic waveform defibrillation reduces the severity of postresuscitation myocardial dysfunction. Crit Care Clin 28:222–224
Babini G, Ruggeri L, Ristagno G (2021) Optimizing defibrillation during cardiac arrest. Curr Opin Crit Care 27(3):246–254. https://doi.org/10.1097/MCC.0000000000000821
doi: 10.1097/MCC.0000000000000821
pubmed: 33797430
Ristagno G, Gullo A, Berlot G, Lucangelo U, Geheb F, Bisera J (2008) Prediction of successful defibrillation in human victims of out-of-hospital cardiac arrest: a retrospective electrocardiographic analysis. Anaesth Intensive Care 36(1):46–50. https://doi.org/10.1177/0310057x0803600108
doi: 10.1177/0310057x0803600108
pubmed: 18326131
Indik JH, Conover Z, McGovern M et al (2014) Association of amplitude spectral area of the ventricular fibrillation waveform with survival of out-of-hospital ventricular fibrillation cardiac arrest. J Am Coll Cardiol 64(13):1362–1369. https://doi.org/10.1016/j.jacc.2014.06.1196
doi: 10.1016/j.jacc.2014.06.1196
pubmed: 25257639
Frigerio L, Baldi E, Aramendi E et al (2021) End-tidal carbon dioxide (ETCO2) and ventricular fibrillation amplitude spectral area (AMSA) for shock outcome prediction in out-of-hospital cardiac arrest. Are they two sides of the same coin? Resuscitation 160:142–149. https://doi.org/10.1016/j.resuscitation.2020.10.032
doi: 10.1016/j.resuscitation.2020.10.032
pubmed: 33181229
Marn-Pernat A, Weil MH, Tang W, Pernat A, Bisera J (2001) Optimizing timing of ventricular defibrillation. Crit Care Med 29(12):2360–2365. https://doi.org/10.1097/00003246-200112000-00019
doi: 10.1097/00003246-200112000-00019
pubmed: 11801840
Povoas HP, Bisera J (2000) Electrocardiographic waveform analysis for predicting the success of defibrillation. Crit Care Med 28(11 SUPPL):210–211. https://doi.org/10.1097/00003246-200011001-00010
doi: 10.1097/00003246-200011001-00010
Perkins GD, Jacobs IG, Nadkarni VM et al (2015) Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein resuscitation registry templates for out-of-hospital cardiac arrest: a statement for healthcare professionals from a task force of the international liaison committee. Circulation 132(13):1286–1300. https://doi.org/10.1161/CIR.0000000000000144
doi: 10.1161/CIR.0000000000000144
pubmed: 25391522
Koster RW, Walker RG, Van Alem AP (2006) Definition of successful defibrillation. Critical Care Med. https://doi.org/10.1097/01.CCM.0000246008.95156.78
doi: 10.1097/01.CCM.0000246008.95156.78
Koster RW, Walker RG, Van Alem AP (2006) Definition of successful defibrillation. Crit Care Med 34(12 SUPPL):423–426. https://doi.org/10.1097/01.CCM.0000246008.95156.78
doi: 10.1097/01.CCM.0000246008.95156.78
Savastano S, Baldi E, Raimondi M et al (2017) End-tidal carbon dioxide and defibrillation success in out-of-hospital cardiac arrest. Resuscitation 121:71–75. https://doi.org/10.1016/j.resuscitation.2017.09.010
doi: 10.1016/j.resuscitation.2017.09.010
pubmed: 28942011
Ristagno G, Li Y, Fumagalli F, Finzi A, Quan W (2013) Amplitude spectrum area to guide resuscitation-A retrospective analysis during out-of-hospital cardiopulmonary resuscitation in 609 patients with ventricular fibrillation cardiac arrest. Resuscitation 84(12):1697–1703. https://doi.org/10.1016/j.resuscitation.2013.08.017
doi: 10.1016/j.resuscitation.2013.08.017
pubmed: 24005007
Berg KM, Soar J, Andersen LW, Adult Advanced Life Support et al (2020) International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. https://doi.org/10.1161/CIR.0000000000000893
doi: 10.1161/CIR.0000000000000893
pubmed: 33296238
pmcid: 7302067
Kette F, Locatelli A, Bozzola M et al (2013) Electrical features of eighteen automated external defibrillators: a systematic evaluation. Resuscitation 84(11):1596–1603. https://doi.org/10.1016/j.resuscitation.2013.05.017
doi: 10.1016/j.resuscitation.2013.05.017
pubmed: 23735652
Ruggeri L, Fumagalli F, Bernasconi F et al (2023) Amplitude spectrum area of ventricular fibrillation to guide defibrillation: a small open-label, pseudo-randomized controlled multicenter trial. eBioMedicine 90:104544. https://doi.org/10.1016/j.ebiom.2023.104544
doi: 10.1016/j.ebiom.2023.104544
pubmed: 36977371
pmcid: 10060104
Schneider T, Martens PR, Paschen H et al (2000) Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Circulation 102(15):1780–1787. https://doi.org/10.1161/01.CIR.102.15.1780
doi: 10.1161/01.CIR.102.15.1780
pubmed: 11023932
Bardy GH, Marchlinski FE, Sharma AD, Worley SJ, Luceri RM, Yee R, Halperin BD, Fellows CL, Ahern TS, Chilson DA, Packer DL, Wilber DJ, Mattioni TA, Reddy R, Kronmal RA, Lazzara R (1996) Multicenter comparison of truncated biphasic shocks and standard damped sine wave monophasic shocks for transthoracic ventricular defibrillation. Transthoracic Investigators. Circulation 94(10):2507–2514. https://doi.org/10.1161/01.cir.94.10.2507
Hurst TM, Hinrichs M, Breidenbach C, Katz N, Waldecker B (1999) Detection of myocardial injury during transvenous implantation of automatic cardioverter-defibrillators. J Am Coll Cardiol 34(2):402–408. https://doi.org/10.1016/S0735-1097(99)00194-1
doi: 10.1016/S0735-1097(99)00194-1
pubmed: 10440152
Sweeney MO, Sherfesee L, DeGroot PJ, Wathen MS, Wilkoff BL (2010) Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients. Hear Rhythm 7(3):353–360. https://doi.org/10.1016/j.hrthm.2009.11.027
doi: 10.1016/j.hrthm.2009.11.027
Zaugg CE, Wu ST, Barbosa V et al (1998) Ventricular fibrillation-induced intracellular Ca2+ overload causes failed electrical defibrillation and post-shock reinitiation of fibrillation. J Mol Cell Cardiol 30(11):2183–2192. https://doi.org/10.1006/jmcc.1998.0777
doi: 10.1006/jmcc.1998.0777
pubmed: 9925356
Mcleod SL, Ph D, Turner L et al (2022) Defibrillation strategies for refractory ventricular fibrillation. N Engl J Med. https://doi.org/10.1056/NEJMoa2207304
doi: 10.1056/NEJMoa2207304
pubmed: 36342151
La G (2000) Evolution of the optimum bidirectional (+/- biphasic) wave for defibrillation. Biomed Instrum Technol 34:39–54