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Ethanol Increases Defibriliation Threshold in Pigs
Author(s) -
KIM YOU HO,
JONES DOUGLAS L.,
NATALE ANDREA,
KLEIN GEORGE J.
Publication year - 1993
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 - 10.1111/j.1540-8159.1993.tb01530.x
Subject(s) - medicine , ventricular fibrillation , saline , defibrillation , anesthesia , ethanol , alcohol , zoology , cardiology , biochemistry , chemistry , organic chemistry , biology
Alcohol ingestion has been associated with cardiac arrhythmias and may initiate fibrillation in patients with automatic defibrillators. The effect of alcohol on defibriliation efficacy is unknown. To assess the acute effects of alcohol on defibrilia‐tion efficacy, triplicate defibrillation thresholds (DFTs) were determined before and after intravenous administration of 25% ethanol. Fifty‐two pigs were randomized into four groups: (1) control, 6 mL/kg of saline over 10 minutes (n = 12); (2) low dose, 6 mL/kg of 25% ethanol over 10 minutes (n = 12); (3) mid dose, 0.45 mL/kg per minute for 30 minutes followed by 0.045 mL/kg per minute for 45 minutes (n = 12); and (4) high dose, 0.45 mL/kg per minute for 30 minutes followed by 0.06 mL/kg per minute for 45 minutes (n = 16). Three coil defibrillating electrodes (Medtronic 6888) were sutured to the epicardium of the right and left ventricles for de/ibrillation shocks. Ventricular fibrillation was induced using alternating current and after 10 seconds of fibrillation, the minimum energy for defibriliation was established using sequential pulse defibriliation. Triplicate determinations were obtained before and after saline or ethanol infusion. Alcohol elevated DFT in a dose related manner. Control and low dose groups thresholds were unchanged, but the mid dose approached statistical significance (6.8 ± 0.7 vs 7.6 ± 0.9 J, 0.05 < P < 0.1)and the high dose was significantly elevated (8.5 ± 0.7vsll.2 ± 1.1 J. P < 0.01). Ventricular effective refractory periods and cycle lengths between fibrillatory waves did not differ before and after the high dose ethanol. These results indicate that high blood levels of ethanol impoir defibriliation efficacy and may result in failure to defibrillate patients with borderline DFTs.