Circulation, Vol 69, 357-368, Copyright © 1984 by American Heart Association
JN Patton, JD Allen and JF Pantridge
Myocardial damage by transthoracic countershocks was assessed by
observation for electrocardiographic loss of R waves and elevation of ST
segments, creatine kinase depletion, and histologic evidence of necrosis in
damaged areas, and by excision and examination, 3 days later, of all tissue
macroscopically observed to be damaged. When 4000 J of stored energy was
passed across the chest of dogs anesthetized with pentobarbital sodium (30
mg/kg), more damage was caused when the energy was divided among 10 shocks
than when it was applied in 20 or 40 shocks (at intervals of 0.5 min). The
prior intravenous administration of verapamil (1 mg/kg) reduced the weight
of damaged shocks. Propranolol (0.4 mg/kg) had no effect. These results
give further evidence for the role of calcium accumulation in cardiac
necrosis after direct current countershocks. Multiple low-energy shocks
cause less cardiac damage than do a few high-energy shocks of similar total
energy.
ARTICLES
The effects of shock energy, propranolol, and verapamil on cardiac damage caused by transthoracic countershock
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