| Reduction of the internal atrial defibrillation threshold with balanced orthogonal sequential shocks. | |
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MedLine Citation:
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PMID: 12380930 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The aim of this study was to determine the atrial defibrillation threshold (ADFT) of a first shock across the standard right atrium (RA) to distal coronary sinus (dCS) configuration followed by a second shock along the atrial septum with a standard sequential waveform (the second shock leading edge equaled the first shock trailing edge) and a balanced sequential waveform (the leading edges of both shocks were equal). METHODS AND RESULTS: In nine sheep atrial fibrillation was induced with acetyl-beta-methylcholine and burst pacing. A catheter was placed with electrodes in the dCS, proximal coronary sinus (pCS), and RA. A J-shaped catheter was positioned with an electrode at Bachmann's bundle (BB) while another catheter was positioned with an electrode in the superior vena cava (SVC). The ADFTs of six single- and dual-pathway configurations were determined with single, standard sequential, or balanced sequential shocks. The ADFT of the RA-->dCS configuration (0.86 +/- 0.27 J, 159 +/- 29 V, 2.42 +/- 0.36 A) was significantly reduced when followed by an SVC-->pCS (0.58 +/- 0.17 J, 112 +/- 20 V, 1.64 +/- 0.39 A) or a BB-->pCS shock (0.64 +/- 0.16 J, 119 +/- 18 V, 1.81 +/- 0.38 A) with standard sequential shocks. With balanced sequential shocks, the peak voltage and current ADFTs were further significantly reduced (85 +/- 11 V and 1.24 +/- 0.21 A for second shock SVC-->pCS, and 93 +/- 13 V and 1.38 +/- 0.27 A for second shock BB-->pCS). CONCLUSION: The ADFT of the standard RA-->dCS shock is significantly reduced when followed by a second shock along the atrial septum delivered between electrodes in the pCS and either SVC or BB and ADFT is further reduced with balanced sequential shocks. |
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Authors:
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Xiangsheng Zheng; Michael E Benser; Gregory P Walcott; William M Smith; Raymond E Ideker |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 13 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-10-16 Completed Date: 2003-02-12 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 904-9 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Atrial Fibrillation / chemically induced, physiopathology, therapy Defibrillators, Implantable* Differential Threshold Disease Models, Animal Electric Countershock* Electric Impedance Electrodes, Implanted Heart Atria / physiopathology, surgery Heart Conduction System / physiopathology, surgery Methacholine Chloride / adverse effects Models, Cardiovascular Parasympathomimetics / adverse effects Sheep Treatment Outcome Vena Cava, Superior / physiopathology, surgery |
| Grant Support | |
ID/Acronym/Agency:
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HL-42760/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Parasympathomimetics; 62-51-1/Methacholine Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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