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Transvenous biventricular defibrillation.

E Meisel1, C Butter, F Philippon

  • 1Heart and Circulation Center, Dresden, Germany.

The American Journal of Cardiology
|November 21, 2000
PubMed
Summary
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Biventricular defibrillation using left ventricular leads is feasible and safe. While not consistently reducing defibrillation thresholds, specific posterolateral placements showed significant reductions in animal studies.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Biventricular pacing success suggests potential for left ventricular leads in other therapies.
  • Animal studies indicated reduced defibrillation strength requirements with left ventricular leads.

Purpose of the Study:

  • To investigate the feasibility and safety of biventricular defibrillation in humans.
  • To compare defibrillation threshold (DFT) reduction using standard versus biventricular shock configurations.

Main Methods:

  • Fifty-one patients undergoing implantable cardioverter defibrillator (ICD) implantation were enrolled.
  • A prototype left ventricular defibrillation lead was inserted via the coronary sinus.
  • Randomized DFT testing compared standard ICD shocks to three biventricular configurations.

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Main Results:

  • Left ventricular lead positioning was successful in 89% of patients.
  • Mean DFTs were not significantly lower across all biventricular configurations.
  • Retrospective analysis revealed significant DFT reduction (p=0.04) with dual shocks in the posterolateral left ventricle.

Conclusions:

  • Biventricular defibrillation is feasible and safe in the tested configurations.
  • Further studies are required to confirm consistent DFT reduction with posterolateral left ventricular lead placement.