Shock wave lithotripsy with the Dornier MFL 5000 lithotriptor using an external fixed rate signal.

Abstract

We examine the effects of fixed rate shock wave administration on the cardiac rhythm and treatment efficacy of a tubless lithotriptor (Dornier MFL 5000*). A secondary goal was to examine the treatment efficacy of fixed shock wave administration compared to R wave triggered lithotripsy. In this prospective study Holter monitoring was used before, during and after nonR wave triggered shock wave lithotripsy. An increase in premature ventricular contractions was noted during shock wave lithotripsy. However, there were no episodes of significant ventricular ectopia, ventricular tachycardia, asystole or heart block as a result of nonR wave triggered shock wave administration. NonR wave gated shock wave lithotripsy expedited patient treatment and (mean treatment time 46 +/- 21 minutes)., minimized the use of sedation during treatment and produced results similar to R wave gated shock wave lithotripsy with the MFL 5000 lithotriptor. With adequate precautions, fixed rate shock wave administration would appear to be a reasonable option to treat urolithiasis with the MFL 5000 lithotriptor as with other newer lithotriptors.