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Nonthoracotomy internal defibrillation in dogs: threshold reduction using a subcutaneous chest wall electrode with a transvenous catheter electrode.

Abstract：

:The efficacy of truncated exponential waveform shocks using a cardioverter-defibrillator catheter with and without a 13.9 cm2 subcutaneous thoracic patch electrode was examined in 10 pentobarbital-anesthetized dogs. The cardioverter-defibrillator catheter was positioned through the external jugular vein with the distal 4 cm2 shocking electrode located in the right ventricular apex and the 8 cm2 proximal electrode located in the superior vena cava. Four electrode configurations were tested: 1) distal electrode (cathode) to proximal electrode and chest wall patch (common anodes), 2) distal electrode (cathode) to chest wall patch (anode), 3) distal electrode (cathode) to proximal electrode (anode), and 4) chest wall patch (cathode) to proximal electrode (anode). The lowest randomized energy resulting in termination of alternating current-induced ventricular fibrillation on four trials at that energy was 20.2, 21.3, 27.4 and greater than 40 J, respectively, for configurations 1 through 4. The energy requirements for configurations 1, 2 and 3 were significantly lower than for configuration 4 (p less than 0.001). Additionally, configurations incorporating the distal electrode and the patch electrode (configurations 1 and 2) were significantly better than the catheter alone (configuration 3; p less than 0.05). There was no significant difference between configurations 1 and 2. In conclusion, the addition of a subcutaneous chest wall electrode to the cardioverter-defibrillator catheter significantly lowered energy requirements for defibrillation, suggesting that a nonthoracotomy approach for the automatic implantable cardioverter-defibrillator is feasible.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Wetherbee JN,Chapman PD,Klopfenstein HS,Bach SM Jr,Troup PJ

doi

10.1016/s0735-1097(87)80025-6

subject

Has Abstract

pub_date

1987-08-01 00:00:00

pages

406-11

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(87)80025-6

journal_volume

pub_type

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Nonthoracotomy internal defibrillation in dogs: threshold reduction using a subcutaneous chest wall electrode with a transvenous catheter electrode.