Document Detail

Bipolar transvenous defibrillation: efficacy of two different positions of the anode.
MedLine Citation:
PMID:  8552512     Owner:  NLM     Status:  MEDLINE    
For most nonthoracotomy defibrillation lead systems, the transvenous anode can positioned independently of the right ventricular (RV) cathode. Usually a vertical position in the superior vena cava (SVC) is chosen. However, it is unknown if this position yields the optimal defibrillation threshold (DFT). Therefore, in 15 patients undergoing defibrillator implantation the SVC position was compared in a crossover study design with a horizontal position in the left brachiocephalic vein (BCV). Mean DFT was not different for SVC and BCV (19.2 +/- 9.6 J vs 18.5 +/- 9.1 J) but DFT of individual patients differed by up to 12 joules. A positive correlation between impedance and DFT in the BCV position (r = 0.6; P < or = 0.05) indicated that the improved geometry of the defibrillation field with the BCV position is opposed by a higher impedance found for this position (63 +/- 15 omega vs 52 +/- 7 omega). Thus, defibrillation is not improved in general although individual patients might benefit.
M Block; D Hammel; D Böcker; M Borggrefe; T Budde; M Castrucci; C Fastenrath; H H Scheld; G Breithardt
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  18     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-02-21     Completed Date:  1996-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1995-2000     Citation Subset:  IM    
Hospital of the Westfälische Wilhelms, University of Münster, Department of Cardiolog/Angiology, Germany.
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MeSH Terms
Brachiocephalic Veins
Cross-Over Studies
Defibrillators, Implantable*
Electric Conductivity
Electric Countershock / methods*
Electric Impedance
Equipment Design
Heart Ventricles
Middle Aged
Prospective Studies
Vena Cava, Superior
Ventricular Fibrillation / physiopathology,  therapy
Reg. No./Substance:
7439-88-5/Iridium; 7440-06-4/Platinum

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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