Ventricular wall thickness and volume during hemodynamic collapse produced by AC leakage current

B. Hoffmeister, B.S. Sheals, A. de Jongh, R. Malkin
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Abstract

Medical equipment can unintentionally allow the flow of power line current through the patient causing complete hemodynamic collapse without fibrillation. This study tests the hypothesis that static wall thickening accompanies AC induced collapse via an isovolumic state. In 3 dogs, we delivered AC current stimulation ranging from 10-160 Hz and 10-1000 /spl mu/A to the right ventricle. A steerable, quadripolar catheter was placed in the apex of the left ventricle and deflected towards the basal region to measure left ventricular volume. Two dimensional, short-axis ultrasound images of the LV endocardial walls were recorded to measure wall thickness. Our results indicate that wall thickness during collapse is significantly greater than during systole (/spl Delta/ thickness =11.7/spl plusmn/12 mm, p<0.001) and diastole (/spl Delta/ thickness=23.6/spl plusmn/13 mm, p<0.001). In addition, the volume of the left ventricle is significantly smaller during collapse than the average volume during normal sinus rhythm (/spl Delta/ impedance=0.152/spl plusmn/0.006 no units, p<0.001).
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交流漏电流引起血流动力学衰竭时的心室壁厚度和容积
医疗设备可能会无意中让电线电流通过患者,导致完全的血流动力学崩溃,而不会引起纤颤。本研究验证了静壁增厚伴随交流诱导塌陷的假设。在3只狗中,我们向右心室施加10-160 Hz和10-1000 /spl mu/A的交流电流刺激。一个可操纵的四极导管被放置在左心室的顶端,并向基底区偏转,以测量左心室容积。记录左室心内膜壁的二维短轴超声图像,测量壁厚。我们的研究结果表明,崩塌时的壁厚明显大于收缩期(/spl Delta/ thickness= 11.7/spl plusmn/ 12mm, p<0.001)和舒张期(/spl Delta/ thickness=23.6/spl plusmn/ 13mm, p<0.001)。此外,心衰时左心室容积明显小于正常窦性心律时的平均容积(/spl δ /阻抗=0.152/spl plusmn/0.006无单位,p<0.001)。
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