Abstract:
INTRODUCTION:Determination of the optimal electrode configuration during implantable cardioverter defibrillator (ICD) implantation remains largely an empirical process. This study investigated the feasibility of using a finite element model of the thorax to predict clinical defibrillation metrics for internal defibrillation in humans. Computed defibrillation metrics from simulations of three common electrode configurations with a monophasic waveform were compared to pooled metrics for similar electrode and waveform configurations reported in humans. METHODS AND RESULTS:A three-dimensional finite element model was constructed from CT cross-sections of a human thorax. Myocardial current density distributions for three electrode configurations (epicardial patches, right ventricular [RV] coil/superior vena cava [SVC] coil, RV coil/SVC coil/subcutaneous patch) and a truncated monophasic pulse with a 65% tilt were simulated. Assuming an inexcitability threshold of 25 mA/cm2 (10 V/cm) and a 75% critical mass criterion for successful defibrillation, defibrillation metrics (interelectrode impedance, defibrillation threshold current, voltage, and energy) were calculated for each electrode simulation. Values of these metrics were within 1 SD of sample-size weighted means for the corresponding metrics determined for similar electrode configurations and waveforms reported in human clinical studies. Simulated myocardial current density distributions suggest that variations in current distribution and uniformity partially explain differences in defibrillation energy requirements between electrode configurations. CONCLUSION:Anatomically realistic three-dimensional finite element modeling can closely simulate internal defibrillation in humans. This may prove useful for characterizing patient-specific factors that influence clinically relevant properties of current density distributions and defibrillation energy requirements of various ICD electrode configurations.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Kinst TF,Sweeney MO,Lehr JL,Eisenberg SRdoi
10.1111/j.1540-8167.1997.tb00822.xsubject
Has Abstractpub_date
1997-05-01 00:00:00pages
537-47issue
5eissn
1045-3873issn
1540-8167journal_volume
8pub_type
杂志文章abstract:INTRODUCTION:The right inferior pulmonary vein (RIPV) accounts as the most frequently reconnected vein after pulmonary vein isolation using second-generation cryoballoon ablation (CB-A). Our objective was to assess anatomic predictors of late RIPV reconnection based on preprocedural computed tomography scan. METHODS:P...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14186
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most commonly encountered clinical arrhythmia, predominantly affecting elderly patients. There is a continued need for new antiarrhythmic drugs to treat the ever-increasing number of patients with this arrhythmia. Dronedarone is a new antiarrhythmic compound currently being de...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1540-8167.2007.01016.x
更新日期:2008-01-01 00:00:00
abstract::A 64-year-old man with atrial tachycardia (AT) 3 years after a superior vena cava (SVC) isolation for atrial fibrillation underwent electrophysiologic testing. SVC mapping with a basket catheter revealed a more frequent activation in the SVC than in either of the atria during the AT and consequently the recovered cond...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00570.x
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:A new strategy to elucidate the molecular mechanisms underlying the long QT syndrome (LQTS) is now available with genetic mutational analyses and characterization of ion channel mutations. METHODS AND RESULTS:In a 26-year-old woman with LQTS, we identified a novel missense mutation in the pore of HERG by ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00304.x
更新日期:1999-09-01 00:00:00
abstract:INTRODUCTION:We conducted this study to examine the effect of the ICD on the outcomes of patients with prior coronary revascularization enrolled in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) and to assess the association of time from coronary revascularization to enrollment with death and sudden cardiac...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01191.x
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:Significant species-, tissue-, and age-dependent differences have been described for the L-type calcium current (ICa). Therefore, extrapolation of data obtained from the many animal models to human cardiac physiology is difficult. In this study, we have characterized the voltage-dependent properties of ICa...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01281.x
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:Myocardial depolarization can be altered by varying pacing stimulus output. This may have implications on response rates for cardiac resynchronization therapy (CRT). The purpose of our study was to determine the relationship of left ventricular (LV) pacing stimulus intensity to measures of depolarization and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01378.x
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:The measurement of microvolt level T wave alternans (TWA) is a technique for detecting arrhythmia vulnerability. Previous studies demonstrated that the magnitude of TWA is dependent on heart rate. However, the effects of antiarrhythmic drugs on TWA are unknown. METHODS AND RESULTS:This was a prospective e...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00241.x
更新日期:1999-05-01 00:00:00
abstract:INTRODUCTION:Outflow tract ventricular arrhythmia (OTVA) can be complicated to target for ablation when originating from either the periaortic or pulmonary valve (PV) region. Both sites may present with a small R wave in lead V1. However, the utility of lead I in distinguishing these arrhythmia locations is unknown. M...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12330
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:Pulmonary vein isolation (PVI) is the cornerstone ablation strategy for treatment of atrial fibrillation (AF). Ablation outside the PVs is sometimes needed particularly in persistent or longstanding AF. This study reported left atrial appendage isolation (LAAI) using cryoballoon (CB) focusing on technical ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13818
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:The incidence of spontaneous transition of 2:1 AV block to 1:1 AV conduction during AV nodal reentrant tachycardia has not been well reported. Among previous studies, controversy also existed about the site of the 2:1 AV block during AV nodal reentrant tachycardia. METHODS AND RESULTS:In patients with 2:1...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2003.03198.x
更新日期:2003-12-01 00:00:00
abstract:INTRODUCTION:Fusion of left ventricular pacing with intrinsic conduction provides superior resynchronization compared to biventricular pacing. His bundle pacing (HBP) preserves intrinsic conduction and allows for constant fusion with left ventricular pacing. This study evaluated sequential His bundle and left ventricul...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14674
更新日期:2020-09-01 00:00:00
abstract::Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00886.x
更新日期:1998-10-01 00:00:00
abstract::Similar to the surgical mini-maze procedure, the posterior "box" lesion set employs linear ablation lesions along the anterior aspects of both sets of PVs connected by a roof line and an inferior line to electrically isolate the PVs and complete posterior LA wall en masse. However, creating fully transmural linear atr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00944.x
更新日期:2008-03-01 00:00:00
abstract:INTRODUCTION:Patients with nonischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) usually have basal-lateral scar in the left ventricle (LV). We sought to determine electrocardiogram (ECG) characteristics that may help identify NICM patients with basal-lateral scar and VT. METHODS AND RESULTS:Phase I, stud...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02129.x
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:Oral anticoagulation (OAC) based on estimated stroke risk is recommended following catheter ablation (CA) of atrial fibrillation (AF), regardless of the extent of arrhythmia control. However, discontinuing OAC in selected patients may be safe. We sought to evaluate a strategy of OAC discontinuation followi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14864
更新日期:2020-12-31 00:00:00
abstract:INTRODUCTION:This study investigated a hybrid approach to reduce the atrial defibrillation threshold (ADFT) by determining the effect of a single linear radiofrequency ablation (RFA) lesion on both the ADFT and activation patterns during atrial fibrillation (AF). METHODS AND RESULTS:In 18 open chest sheep (45 to 57 kg...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00463.x
更新日期:2001-04-01 00:00:00
abstract:INTRODUCTION:For radiofrequency (RF) ablation, the EP Shuttle® (Stockert GmbH, Freiburg, Germany), Ampere® (St. Jude Medical, St. Paul, MN, USA), and SmartAblate® (Biosense Webster, Diamond Bar, CA, USA) generator models are most frequently used in clinical practice. The aim of this study was to assess the correlation ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13386
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:The purpose of this investigation is to evaluate whether a prolonged detection interval for life threatening ventricular tachyarrhythmia (VT) is able to reduce therapies (Rx) delivered by an implantable cardioverter/defibrillator (ICD). Until now, only the PREPARE trial demonstrated a reduction of ICD Rx i...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1540-8167.2008.01415.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:We sought to systematically investigate the role of the ligament of Marshall (LOM) and inferior left ganglionated plexi (ILGP) in modulating electrophysiological functions. METHODS:The following structures were exposed in 36 dogs: (1) LOM, (2) superior left GP (SLGP) near the junction of left superior pulmo...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01315.x
更新日期:2009-03-01 00:00:00
abstract:UNLABELLED:Early Repolarization in Noncompaction Cardiomyopathy. BACKGROUND:Early repolarization (ER) is associated with malignant ventricular arrhythmias, including ventricular fibrillation (VF) and sudden cardiac death (SCD). One possible mechanism is increased trabeculation with deep intramyocardial invagination, ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2012.02325.x
更新日期:2012-09-01 00:00:00
abstract:INTRODUCTION:Immediate reinitiation of atrial tachyarrhythmia (IRAT) is an important cause of failure to maintain sinus rhythm. IRAT prevention by overdrive pacing has not been evaluated in a prospective randomized trial. METHODS AND RESULTS:Patients with a DDDRP pacemaker offering temporary atrial overdrive pacing af...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1540-8167.2003.03160.x
更新日期:2003-09-01 00:00:00
abstract::We present a unique case where early proarrhythmic and late antiarrhythmic characteristics of interatrial conduction delay were observed during the long-term progression of HCM. Occurrence of AT constantly increased as the interatrial conduction delay became more prominent, while the P-wave width in sinus rhythm and t...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01893.x
更新日期:2011-05-01 00:00:00
abstract:INTRODUCTION:Longer observational time and adenosine challenge have proven to be able to detect pulmonary vein (PV) reconnections. The aim of this study was to assess incidence of spontaneous and adenosine-induced PV reconnection after ablation with second-generation cryoballoon (CB-Adv). METHODS AND RESULTS:Fifty con...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12421
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:We prospectively compared the efficacy, safety, and quality of life (QoL) impact of catheter ablation versus antiarrhythmic drugs (AAD) in elderly patients with persistent atrial fibrillation (AF). METHODS AND RESULTS:Four hundred and twelve consecutive patients, aged ≥ 70 years, underwent ablation (Group A...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/jce.12126
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Patients with left bundle branch block (LBBB) undergoing right heart catheterization can develop complete heart block (CHB) or right bundle branch block (RBBB) in response to right bundle branch (RBB) trauma. We hypothesized that LBBB patients with an initial r wave (>or=1 mm) in lead V1 have intact left to ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01714.x
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation (AF). METHODS:Five hundred and four amiodarone-naïve patients were randomized to receive dronedarone 400 mg bid (n = 249) or amiodarone 600 mg qd for 28 days then 200 mg qd (n = 255) for at le...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1540-8167.2010.01764.x
更新日期:2010-06-01 00:00:00
abstract::QT dispersion is defined as the difference in QT interval between the different leads of the surface 12-lead ECG. This may provide an indirect measure of the underlying inhomogeneity of myocardial repolarization, which is believed to be important in arrhythmogenesis. Methodology for determining QT dispersion varies si...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1994.tb01190.x
更新日期:1994-08-01 00:00:00
abstract:INTRODUCTION:A major drawback of therapy with an implantable defibrillator is the nonspecificity of detection. Theoretically, adding atrial sensing information to a decision algorithm could improve specificity of detection. METHODS AND RESULTS:This open-label nonrandomized study compares the detection algorithm of the...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.1999.tb01261.x
更新日期:1999-07-01 00:00:00
abstract:INTRODUCTION:The reason for the increased defibrillation efficacy of biphasic shocks over monophasic shock is not definitely known. METHODS AND RESULTS:In six anesthetized pigs, we mapped the epicardium after transvenous defibrillation shocks to compare the activation patterns following successful biphasic shocks with...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00533.x
更新日期:1996-04-01 00:00:00