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Amplitude Spectrum Area as a Predictor of Successful Defibrillation

  • Conference paper
Anaesthesia, Pharmacology, Intensive Care and Emergency Medicine A.P.I.C.E.

Abstract

Cardiac arrest represents a dramatic event that can occur suddenly and often without warning signs. Cardiopulmonary resuscitation (CPR), including chest compression often in conjunction with electrical defibrillation, has the potential to restore spontaneous circulation (ROSC). However, CPR is likely to be successful only if it is instituted within 5 min after the heart stops beating [1–3]. Ventricular fibrillation (VF) is the primary rhythm in many cases of human cardiac arrest, and defibrillation by electric countershock represents the treatment of choice for this otherwise lethal arrhythmia. VF duration remains a main determinant of countershock success. When the interval between estimated VF onset and delivery of the first shock is >5 min, the likelihood is that an immediate defibrillation attempt will be successful [4–6]. When the duration of untreated VF is >5 min, both human and animal studies demonstrate that initial CPR with chest compression prior to delivery of an electrical shock improves the likelihood of ROSC [7–10]. During cardiac arrest, coronary blood flow ceases, accounting for progressive and severe energy imbalance. Intramyocardial hypercarbic acidosis is associated with depletion of high-energy phosphates and correspondingly severe global myocardial ischaemia [11, 12]. The ischaemic left ventricle (LV) becomes contracted [13], ushering in the stone heart [14, 15]. After onset of contracture, the probability of successful defibrillation is remote. Early CPR that restores coronary perfusion pressure (CPP) and myocardial blood flow delays onset of ischaemic myocardial injury and facilitates delibrillation [16].

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  1. G. Ristagno
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  2. Y. Li
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  3. A. Gullo
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  4. J. Bisera
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  1. Department and School of Anaesthesia and Intensive Care, Catania University-Hospital, Catania, Italy

    Antonino Gullo

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Ristagno, G., Li, Y., Gullo, A., Bisera, J. (2011). Amplitude Spectrum Area as a Predictor of Successful Defibrillation. In: Gullo, A. (eds) Anaesthesia, Pharmacology, Intensive Care and Emergency Medicine A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2014-6_13

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