Abstract 591: Can Waveform Characteristics Predict Defibrillation to a Perfusing Rhythm in Short Versus Prolonged Ventricular Fibrillation in a Swine Model?

Abstract

It is known that defibrillation of ventricular fibrillation (VF) to a perfusing rhythm (ROSC) is more likely to occur in VF of short duration. It is unknown whether ROSC can be predicted by waveform characteristics in VF of short compared to long duration, apart from a consideration of time alone. VF was untreated for 2 minutes (N=10) or 8 minutes (N=10) in normal swine, after which a defibrillation shock was applied. Chest compressions for two minutes were allowed following but not prior to the shock to achieve a perfusing rhythm (ROSC). VF was analyzed from needle electrodes prior to the shock for amplitude spectral area (AMSA), slope, median frequency and bandwidth. Predictors of ROSC were determined by logistic regression. In VF of 2 minute duration 7 out of 10 swine achieved ROSC compared to 2 out 10 swine with VF of 8 minutes (P=0.025) and time was a significant predictor of ROSC (P=0.033). AMSA was significantly higher at 2 minutes (75 ± 18 mV-Hz) compared to 8 minutes (56±11 mV-Hz, p=0.007) as was slope (3.5±1 vs 2.6±0.5 mV/s, p=0.015). Bandwidth was slightly increased from 2.2±0.6 Hz at 2 minutes to 2.8±0.8 Hz at 8 minutes,(p=0.048), while median frequency was similar. However, no waveform characteristic was a significant predictor of ROSC, with substantial overlap in distributions between animals with and without ROSC. Duration of VF is an important determinant of the likelihood of achieving ROSC with defibrillation. Particularly in VF of short duration, VF waveform characteristics do not add to the predictability of achieving ROSC even though they may demonstrate a significant time evolution.