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11.3 Post shock Arrhythmias
Another complication of DC countershock is that of post-shock arrhythmias. As already discussed, higher energy shocks are not always guaranteed to be successful and may in fact be detrimental. Other workers have found that the probability of success decreases for transthoracic defibrillation if the shock strength is too high [Jones JL et al. 1980, Schuder JC et al. 1967]. Many external defibrillation studies have shown that more arrhythmias occur after high rather than low energy shocks [Eick RET et al. 1967, Waldecker B et al. 1986, Peleska B 1963]. This has also been confirmed for catheter-patch electrode configuration systems. One particular study showed that increasing shock strength did not always improve the probability of defibrillation success and was possibly associated with an increased incidence of postshock arrhythmias [Cates AW et al. 1994].
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