直流电复率（DC rate of return）.docVIP

直流电复率（DC rate of return） Direct current cardioversion and defibrillation Derek Preface Cardioversion is the direct release of the QRS wave group from the electrocardiogram to the heart for converting atrial and ventricular arrhythmias into sinus rhythm. This law was invented in 1962 and is a major breakthrough in the history of arrhythmia treatment. Electrical defibrillation, that is, asynchronous cardioversion, is used when QRS wave and T wave are indistinguishable or absent, such as ventricular flutter and fibrillation. I. Basic Principles The rhythmic flow of the current through the heart has a certain order and a uniform form, such as disruption of this form and unity, which results in supraventricular or ventricular arrhythmias. The mechanism may be increased automaticity, reentrant loop, or posterior depolarization. Through direct or transthoracic cardiac release DC can cause the heart to restore sinus rhythm, the current release can make different number of myocardial fiber depolarization, thereby interrupting reentrant loop termination of supraventricular or sinus arrhythmia. A considerable amount of myocardial involvement is required to maintain ventricular fibrillation. Except for a certain number of cardiac muscle, the number of excitable myocardium is reduced, which is not enough to maintain ventricular fibrillation. Thus, when the number of excitatory myocardium decreases to less than the critical myocardial number required to maintain ventricular fibrillation, defibrillation succeeds and terminates arrhythmias, allowing the sinoatrial node to have the opportunity to regain control of the heart as the dominant pacemaker. Two vulnerable period The heart is particularly vulnerable to fibrillation during the so-called vulnerable period. The starting and stopping points are on the T wave, and the electrocardiogram represents the first 30 milliseconds of the T wave peak. At this point, the minimum amount of ventricular fibrillation is required. In ischemic h