| Lack of benefit of an active pectoral pulse generator on atrial defibrillation thresholds. | |
| | |
MedLine Citation:
|
PMID: 12033348 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Atrial defibrillation can be achieved with standard implantable cardioverter defibrillator leads, which has led to the development of combined atrial and ventricular devices. For ventricular defibrillation, use of an active pectoral electrode (active can) in the shocking pathway markedly reduces defibrillation thresholds (DFTs). However, the effect of an active pectoral can on atrial defibrillation is unknown. METHODS AND RESULTS: This study was a prospective, randomized, paired comparison of two shock configurations on atrial DFTs in 33 patients. The lead system evaluated was a dual-coil transvenous defibrillation lead with a left pectoral pulse generator emulator. Shocks were delivered either between the right ventricular coil and proximal atrial coil (lead) or between the right ventricular coil and an active can in common with the atrial coil (active can). Delivered energy at DFT was 4.2 +/- 4.1 J in the lead configuration and 5.0 +/- 3.7 J in the active can configuration (P = NS). Peak current was 32% higher with an active can (P < 0.01), whereas shock impedance was 18% lower (P < 0.001). Moreover, a low threshold (< or = 3 J) was observed in 61% of subjects in the lead configuration but in only 36% in the active can configuration (P < 0.05). There were no clinical predictors of the atrial DFT. CONCLUSION: These results indicate that low atrial DFTs can be achieved using a transvenous ventricular defibrillation lead. Because no benefit was observed with the use of an active pectoral electrode for atrial defibrillation, programmable shock vectors may be useful for dual-chamber implantable cardioverter defibrillators. |
| | |
Authors:
|
Michael R Gold; Stephen R Shorofsky; Rachida Bouhouch; Robert A Joy; D Scott Kirby; Ahmed F Osman; Eric J Rashba |
Related Documents
:
|
11055688 - Emergencies related to implantable cardioverter-defibrillators. 9230868 - Cardiopulmonary resuscitation: a promise as yet largely unfulfilled. 4795748 - Psychologic stress and threshold for repetitive ventricular response. 10608198 - Planning for scholastic cardiac emergencies: the ripley project. 665318 - Supraventricular tachyarrhythmias in acute myocardial infarction. 17359218 - Review of the taxus liberté sr paclitaxel-eluting coronary stent. |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: Journal of cardiovascular electrophysiology Volume: 13 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2002 Apr |
Date Detail:
|
Created Date: 2002-05-29 Completed Date: 2002-12-04 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
|
Languages: eng Pagination: 332-5 Citation Subset: IM |
Affiliation:
|
Division of Cardiology, Medical University of South Carolina, Charleston 29425, USA. Goldmr@musc.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Atrial Fibrillation
/
physiopathology*,
therapy* Defibrillators, Implantable* Differential Threshold Electric Countershock / instrumentation, methods* Electrodes, Implanted Female Heart Rate Humans Male Middle Aged Pectoralis Muscles Sensitivity and Specificity Treatment Outcome Ventricular Fibrillation / physiopathology, therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Changes in repolarization properties with long-term cardiac memory modify dispersion of repolarizati...
Next Document: Pediatric radiofrequency catheter ablation registry success, fluoroscopy time, and complication rate...