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Related Experiment Videos

Biventricular shocking leads improve defibrillation efficacy.

Y Yamanouchi1, I R Efimov, K A Mowrey

  • 1The Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195, USA. tchoup@ccf.org

Journal of Cardiovascular Electrophysiology
|June 4, 1999
PubMed
Summary
This summary is machine-generated.

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Adding a left ventricular (LV) lead to a defibrillation system significantly improves defibrillation efficacy for ventricular arrhythmias. A biventricular configuration with consistent lead polarity is recommended for reduced defibrillation threshold energy.

Area of Science:

  • Cardiovascular Electrophysiology
  • Medical Device Technology

Background:

  • Single lead active can defibrillation systems are standard for life-threatening ventricular arrhythmias.
  • Inadequate defibrillation threshold (DFT) can occur with single lead configurations.

Purpose of the Study:

  • To evaluate if adding a left ventricular (LV) lead enhances defibrillation efficacy.
  • To compare DFT in different lead configurations.

Main Methods:

  • A pig ventricular fibrillation model was used.
  • Three transvenous defibrillation leads (RV, LV, SVC) and an active can were implanted.
  • DFT was measured for seven lead combinations using a biphasic waveform.

Main Results:

  • A biventricular leads active can configuration reduced DFT stored energy by ~35% compared to a single RV lead configuration (9.6 J vs 15.0 J, P=0.02).

Related Experiment Videos

  • Consistent polarity between RV and LV leads was crucial for this reduction.
  • Adding a superior vena cava (SVC) lead further decreased DFT energy (8.4 J).

    • Conclusions:

    • Biventricular leads active can configuration significantly improves defibrillation efficacy.
    • Consistent polarity of right ventricle (RV) and LV leads is essential in this configuration.