A Systematic Review of the Transthoracic Impedance during Cardiac Defibrillation

Heyer, Yasmine; Baumgartner, Daniela; Baumgartner, Christian

doi:10.3390/s22072808

Cited by 13 publications

(8 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The importance of TTI is further supported by a recent meta-analysis, concluding that skeletal muscles shunt away 82% of the electrical current while lung tissue shunts away 14% of the heart so that only 4% of the total level of electrical current reaches the heart [7]. This, besides raising some clinical questions, reinforces the need to gain a better understanding and insight into the factors that influence the level of TTI, hence the extent of electric current flow.…”

Section: Relevance Of the Chaptermentioning

confidence: 85%

The Influence of Transthoracic Impedance on Electrical Cardioversion and Defibrillation: Current Data

Pal-Jakab,

Nagy,

Kiss

et al. 2024

Updates on Cardiac Defibrillation, Cardioversion and AED Development

View full text Add to dashboard Cite

Sudden cardiac death (SCD) is a leading cause of death globally, often caused by malignant ventricular arrhythmias. Rapid termination by direct current defibrillation (DF) is the best way to treat pulseless ventricular tachycardia and ventricular fibrillation. Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. External cardioversion (ECV) is an immediate, effective, and safe procedure for the treatment of arrhythmias with high ventricular rate, for example, AF. The success of both ECV and DF is dependent on the delivery of sufficient current, influenced by energy and transthoracic impedance (TTI). TTI depends on patient characteristics, and the exact factors affecting it are still a matter of debate. Influencing factors such as respiration phase, contact pressure, coupling agent, and total energy delivered are commonly identified. However, there are multiple studies with controversial results concerning the effect of age, gender, body mass index, hemoglobin concentration, the presence of chronic heart failure, and fluid accumulation as independent predictors of TTI. The review emphasizes refining energy dosage during ECV and while minimizing complications caused by an unnecessarily high energy delivery. The value of TTI should be predicted to optimize the energy dosage and the number of shocks for successful ECV and DF.

show abstract

Section: Relevance Of the Chaptermentioning

confidence: 85%

The Influence of Transthoracic Impedance on Electrical Cardioversion and Defibrillation: Current Data

Pal-Jakab,

Nagy,

Kiss

et al. 2024

Updates on Cardiac Defibrillation, Cardioversion and AED Development

View full text Add to dashboard Cite

show abstract

“…The second is the effect of ventilations during analysis and their relationship with impedance as well as the Threshold of Ventricular Fibrillation (TTI), which increases during ventilation and decreases during expiration. 19 , 24 …”

Section: Discussionmentioning

confidence: 99%

Increasing ventilation in drowning resuscitation − A cross-over randomized simulation study of ventilation during automated external defibrillator analysis pauses

Fernández-Méndez,

Barcala-Furelos,

Otero-Agra

et al. 2024

Resuscitation Plus

View full text Add to dashboard Cite

“…Transthoracic impedance is affected by shock waveforms, coupling devices, electrode size and position, respiration, lung volume, and respiration phase [ 21 ]. High transthoracic impedance necessitates multiple shocks and greater energy delivery for successful defibrillation [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Development of an automatic device performing chest compression and external defibrillation: An animal-based pilot study

Roh

Jung

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Background Automatic chest compression devices (ACCDs) can promote high-quality cardiopulmonary resuscitation (CPR) and are widely used worldwide. Early application of automated external defibrillators (AEDs) along with high-quality CPR is crucial for favorable outcomes in patients with cardiac arrest. Here, we developed an automated CPR (A-CPR) apparatus that combines ACCD and AED and evaluated its performance in a pilot animal-based study. Methods Eleven pigs (n = 5, A-CPR group; n = 6, ACCD CPR and AED [conventional CPR (C-CPR)] group) were enrolled in this study. After 2 min observation without any treatment following ventricular fibrillation induction, CPR with a 30:2 compression/ventilation ratio was performed for 6 min, mimicking basic life support (BLS). A-CPR or C-CPR was applied immediately after BLS, and resuscitation including chest compression and defibrillation, was performed following a voice prompt from the A-CPR device or AED. Hemodynamic parameters, including aortic pressure, right atrial pressure, coronary perfusion pressure, carotid blood flow, and end-tidal carbon dioxide, were monitored during resuscitation. Time variables, including time to start rhythm analysis, time to charge, time to defibrillate, and time to subsequent chest compression, were also measured. Results There were no differences in baseline characteristics, except for arterial carbon dioxide pressure (39 in A-CPR vs. 33 in C-CPR, p = 0.034), between the two groups. There were no differences in hemodynamic parameters between the groups. However, time to charge (28.9 ± 5.6 s, A-CPR group; 47.2 ± 12.4 s, C-CPR group), time to defibrillate (29.1 ± 7.2 s, A-CPR group; 50.5 ± 12.3 s, C-CPR group), and time to subsequent chest compression (32.4 ± 6.3 s, A-CPR group; 56.3 ± 10.7 s, C-CPR group) were shorter in the A-CPR group than in the C-CPR group (p = 0.015, 0.034 and 0.02 respectively). Conclusions A-CPR can provide effective chest compressions and defibrillation, thereby shortening the time required for defibrillation.

show abstract

A Systematic Review of the Transthoracic Impedance during Cardiac Defibrillation

Cited by 13 publications

References 79 publications

The Influence of Transthoracic Impedance on Electrical Cardioversion and Defibrillation: Current Data

The Influence of Transthoracic Impedance on Electrical Cardioversion and Defibrillation: Current Data

Increasing ventilation in drowning resuscitation − A cross-over randomized simulation study of ventilation during automated external defibrillator analysis pauses

Development of an automatic device performing chest compression and external defibrillation: An animal-based pilot study

Contact Info

Product

Resources

About