Energy Dose for Defibrillation

To the Editor: In their Sounding Board in the June 1 issue of the Journal Lown and his colleagues point out important aspects of a controversy about the electrical-energy requirements for ventricular defibrillation of human subjects. We applaud the defibrillation success rates achieved with low energy, and we share this group's concern about use of excessive energy, which can produce cardiac damage if used improperly. However, we cannot agree with the implication that the dose concept for ventricular defibrillation is invalid just because some physicians have achieved success with lower energies than others, or because the best electrical dose for.