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January 4, 1964JAMA

Repeated Direct-Current Countershock Without Myocardial Injury

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Why the study?

Does repeated direct-current countershock cause myocardial injury in a patient with refractory arrhythmias?

Population

A 62-year-old man with hypertension and arrhythmias refractory to drug therapy (n=1).

Design

Case_report

Authors

TKThomas Q. KongVentura CollegeWPWilliam L. ProudfitCleveland Clinic

Discussion

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Implication

No myocardial damage after 140 countershocks in one case; hypothesis-generating and should not change practice.

Key Points

  • To evaluate whether repeated direct-current countershocks cause structural or pathological myocardial damage in a patient with refractory arrhythmias.
  • Case report and post-mortem evaluation of a 62-year-old male with hypertension and refractory arrhythmias treated at Cleveland Clinic Hospital (N=1).
  • Autopsy examination of cardiac tissue to assess histological evidence of electric burns, necrosis, and myocardial injury following repeated shocks.
  • Direct-current countershock was administered at least 140 times to manage recurrent, drug-refractory arrhythmias throughout the clinical course.
  • Post-mortem autopsy examination revealed no detectable myocardial injury, necrosis, or structural tissue damage attributable to repeated electrical shocks.

Structured PICO

Does repeated direct-current countershock cause myocardial injury in a patient with refractory arrhythmias?

P
Population
A 62-year-old man with hypertension and arrhythmias refractory to drug therapy (n=1).
I
Intervention
Repeated direct-current (DC) countershock (at least 140 times).
O
Outcome
Myocardial injury assessed at autopsy.safety

Repeated DC countershock (at least 140 times) did not cause myocardial injury in this patient, providing evidence for the safety of the procedure regarding myocardial damage.

Cite This Study

Kong et al. (1964) studied this question.

synapsesocial.com/papers/6a86c68da810ea404bcf84abhttps://doi.org/10.1001/jama.1964.03060140066024
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Complications and Limitations of Direct-Current Countershock1964 · 128 citations
  2. 2Complications and Limitations of Direct-Current Countershock1965 · 17 citations
  3. 3Comparison of Countershock with Direct and Alternating Current in External Cardiac Defibrillation1963 · 9 citations
  4. 4Ventricular Tachycardia After Synchronized Direct-Current Countershock1964 · 16 citations
  5. 5Myocardial Changes After Direct Current Electroshock1964 · 22 citations