SHOCK-WAVE LITHOTRIPSY WITH THE DORNIER MFL-5000 LITHOTRIPTOR USING AN EXTERNAL FIXED RATE SIGNAL

Purpose: We examine the effects of fixed rate shock wave administratio n on the cardiac rhythm and treatment efficacy of a tubless lithotript or (Dornier MFL 5000). A secondary goal was to examine the treatment efficacy of fixed shock wave administration compared to R wave trigger ed lithotripsy. Materials and Methods: In this prospective study Holte r monitoring was used before, during and after non R wave triggered sh ock wave lithotripsy. Results: An increase in premature ventricular co ntractions was noted during shock wave lithotripsy. However, there wer e no episodes of significant ventricular ectopia, ventricular tachycar dia, asystole or heart block as a result of non R wave triggered shock wave administration. Non R wave gated shock wave lithotripsy expedite d patient treatment (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. Co nclusions: With adequate precautions, fixed rate shock wave administra tion would appear to be a reasonable option to treat urolithiasis with the MFL 5000 lithotriptor as with other newer lithotriptors.