Key result
Transesophageal defibrillation was as effective as transthoracic defibrillation in a canine model (DFT 90 vs 115 joules) and successfully terminated refractory VF in 4 patients.
Why the study?
Does transesophageal defibrillation effectively terminate ventricular fibrillation compared to transthoracic defibrillation in a canine model and in patients with refractory VF?
Population
14 anesthetized dogs with induced ventricular fibrillation, and 4 patients with out-of-hospital refractory…
Comparison
Transesophageal defibrillation using an… vs Transthoracic defibrillation.
Design
Preclinical, Random order for transesophageal and transthoracic DFT…
Follow-up
4 weeks for chronic dogs; initial resuscitation period for…
Authors
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Transesophageal defibrillation merits further study for refractory VF; hypothesis-generating from animal and small-case data, should not yet change practice.
Does transesophageal defibrillation effectively terminate ventricular fibrillation compared to transthoracic defibrillation in a canine model and in patients with refractory VF?
Absolute Event Rate: 90% vs 115%
p-value: p=not statistically significant
Transesophageal defibrillation is a feasible and potentially effective rescue strategy for refractory ventricular fibrillation when transthoracic shocks fail, though clinical survival remains poor in prolonged arrests.
Cohen et al. (1993) studied Ventricular fibrillation (n=18). Transesophageal defibrillation vs. Transthoracic defibrillation was evaluated on Defibrillation threshold (DFT) (p=not statistically significant). Transesophageal defibrillation was as effective as transthoracic defibrillation in a canine model (DFT 90 vs 115 joules) and successfully terminated refractory VF in 4 patients.
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