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Internal Defibrillation: Pain Perception of Low Energy Shocks
Author(s) -
STEINHAUS DAVID M.,
CARDINAL DEBBIE S.,
MONGEON LUC,
MUSLEY SHAILESH KUMAR,
FOLEY LAURA,
CORRIGAN SUSIE
Publication year - 2002
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2002.01090.x
Subject(s) - medicine , tolerability , defibrillation , perception , low energy , cardiology , anesthesia , adverse effect , physics , atomic physics , neuroscience , biology
STEINHAUS, D.M., et al. : Internal Defibrillation: Pain Perception of Low Energy Shocks. Recently, device‐based low energy cardoversion shocks have been used as therapy for AF. However, discomfort from internal low energy electrical shocks is poorly understood. The aim of this study was to evaluate pain perception with low energy internal discharges. Eighteen patients with ICD devices for malignant ventricular arrhythmias were recruited to receive shocks of 0.4 and 2 J in the nonsedated state. Discharges were delivered in a blinded, random order and questionnaires were used to determine discomfort levels and tolerability. Patients perceived discharges at these energies as relatively uncomfortable, averaging a score of 7.3 on a discomfort scale of 0–10, and could not distinguish 0.4‐J shocks from 2‐J shocks. Second shocks were perceived as more uncomfortable than initial discharges, regardless of the order in which the shocks were delivered. Despite the perceived discomfort, 83% of patients stated that they would tolerate discharges of this magnitude once per month, and 44% would tolerate weekly discharges. Patients perceive low energy discharges as painful and cannot distinguish between shocks of 0.4 and 2 J. The results suggest that ICD systems developed to treat atrial tachyarrhythmias should minimize the number of shocks delivered to terminate an atrial tachyarrhythmia episode. The majority of the patients tolerated low energy shocks provided the discharges are infrequent (once per month).