Dependence on the scattering angle of the electron temperature and electron density in thomson-scattering measurements on an atmospheric-pressure plasma jet

Electron temperature and electron density measurements were made in an atmospheric-pressure argon plasma jet by line-shape analysis of Thomson-scattered laser light. The dependence of electron temperature and electron density on the scattering angle was investigated. Measurements were made using incident laser wavelengths of 532 and 355 nm. At 532 nm, the electron-ion collision frequency exceeds the Landau damping rate for shallow scattering angles, and the electron plasma wave resonance structure in the Thomson line shape is broadened. This resulted in dramatic increase in the apparent electron temperature as a function of decreasing scattering angle. At 355 nm, collisions do not affect the Thomson line shape. In this case, an angular dependence of the measured electron temperature is not expected and was not observed. Data taken at 532 nm at larger scattering angles are consistent with the 355-nm results, and show that the electrons are not in thermodynamic equilibrium with the heavy particles.

A randomized, double-blind, placebo-controlled, dose-ranging study of dofetilide in patients with inducible sustained ventricular tachyarrhythmias

INTRODUCTION

Dofetilide is a new antiarrhythmic agent with potent IK blocking properties in vitro. We developed a dose-ranging, placebo-controlled study design to define the range of effective doses and to evaluate the clinical electrophysiology of intravenous dofetilide in patients in whom sustained ventricular tachycardia or fibrillation was reproducibly inducible at baseline electrophysiologic testing.

METHODS AND RESULTS

The initial four patients received low doses that were increased in subsequent groups of four if adverse effects were absent. In each group of four patients, one patient was randomly assigned to placebo (double blind). Twenty-four patients were studied at six incremental loading and maintenance infusion regimens. Dofetilide (0.1 to 8.0 ng/mL) produced concentration-related increases in the % delta of QT (r = 0.79, P < 0.001), QTc (r = 0.60, P = 0.02), RR (r = 0.62, P < 0.02), and right ventricular effective refractory period (cycle length 600 msec; r = 0.68, P = 0.04). Placebo produced no changes in any of these measurements. Sustained ventricular tachycardia or ventricular fibrillation was no longer inducible in 1 of 6 patients receiving placebo and 8 of 18 receiving dofetilide (4 to 13 sec nonsustained ventricular tachycardia was induced in 4 of these 8). One patient developed torsades de pointes at a high concentration (5.3 ng/mL).

CONCLUSIONS

We conclude that: (1) dofetilide produces concentration-related IK blocking effects in patients; (2) an incremental dose-ranging study design aids in identifying the range of doses demonstrating electrophysiologic effects and efficacy; (3) a concomitant placebo group provides important data to assess reproducibility of results over time; and (4) further studies of dofetilide's efficacy and toxicity should be conducted.

Effects of procainamide and lidocaine on defibrillation energy requirements in patients receiving implantable cardioverter defibrillator devices

INTRODUCTION

In acute canine studies, lidocaine, but not procainamide, increases defibrillation energy requirements. We evaluated the effects of lidocaine or procainamide on defibrillation energy requirements in 27 patients undergoing intraoperative testing for implantable cardioverter defibrillator device placement.

METHODS AND RESULTS

Patients were tested off antiarrhythmic drugs and again following either lidocaine (200 to 250 mg loading and 3 mg/min maintenance infusions) or procainamide (1 gm loading and 3 to 4 mg/min maintenance infusions). The defibrillation testing protocol consisted of initial testing at 15 J, followed by higher or lower energies to determine the lowest energy producing three consecutive successful defibrillations. Overall, the mean defibrillation energy increased from 14 +/- 5 J to 18 +/- 7 J during lidocaine (plasma concentration 5.1 +/- 1.6 micrograms/mL; P < 0.02) but were similar at baseline (12 +/- 5 J) and during procainamide infusion (13 +/- 6 J) (plasma concentration: procainamide 10.7 +/- 7.2 micrograms/mL; N-acetyl procainamide 1.0 +/- 0.4 micrograms/mL). A positive linear correlation was found between lidocaine plasma concentration and percent change in defibrillation energy (lidocaine: r = 0.61; P = 0.01). Procainamide raised the defibrillation energy in three patients, two with supratherapeutic plasma concentrations. The increase in defibrillation energy equaled or exceeded 25 J in four patients after lidocaine and in one patient after procainamide.

CONCLUSION

The data suggest that at high plasma concentrations, lidocaine and procainamide adversely affect defibrillation energy requirements consistent with an adverse, concentration-dependent effect of sodium channel blockade on defibrillation energy requirements in patients.