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Coronary Blood Flow Produced by Muscle Contractions Induced by Intracardiac Electrical CPR during Ventricular Fibrillation
Author(s) -
WANG HAO,
TANG WANCHUN,
TSAI MINSHAN,
SUN SHIJIE,
LI YONGQIN,
GILMAN BYRON,
KROLL MARK W.,
GUAN JUN,
BREWER JAMES E.,
WEIL MAX H.
Publication year - 2009
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.1540-8159.2008.02287.x
Subject(s) - medicine , cardiology , ventricular fibrillation , intracardiac injection , skeletal muscle , perfusion , cardiopulmonary resuscitation , anesthesia , resuscitation
It has been reported that transthoracic electrical cardiopulmonary resuscitation (ECPR) generates coronary perfusion pressures (CPP) similar to manual chest compressions (MCC). We hypothesized that intracardiac ECPR produces similar CPP.Methods: ECPR pulse train protocols were applied for 20 seconds in a porcine model following 10 seconds of ventricular fibrillation (VF), using a defibrillator housing electrode and a right ventricular coil (IC‐ECPR). Each protocol consisted of 200‐ms electrical pulse trains applied at a rate of 100 pulse trains/min. The protocols were grouped in skeletal‐based versus cardiac‐based stimulation measurements. CPP was recorded and compared to historical MCC values generated by a similar experimental design. CPP > 15 mm Hg at 30 seconds of VF following the application of an IC‐ECPR protocol was defined as successful.Results: Mean CPP for all intracardiac ECPR pulse train protocols at 30 seconds of VF was 14.8 ± 3.8 mm Hg (n = 39). Mean CPP in seven successful skeletal‐based IC‐ECPR protocols was 19.4 ± 3.2 mm Hg, and mean CPP in 10 successful cardiac‐based IC‐ECPR protocols was 17.4 ± 2.1 mm Hg. Reported CPP for 15 MCC experiments at 30 seconds of VF was 22.9 ± 9.4 mm Hg (P = 0.35 compared to skeletal‐based IC‐ECPR, P = 0.08 compared to cardiac‐based IC‐ECPR).Conclusions: Intracardiac applied electrical CPR produced observable skeletal muscle contractions, measurable pressure pulses, and coronary perfusion pressures similar to MCC during a brief episode of untreated VF.