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Related Experiment Videos

Distal right ventricular coil position reduces defibrillation thresholds.

Eric J Rashba1, Matt Bonner, John Wilson

  • 1Division of Cardiology, University of Maryland School of Medicine, Baltimore, Maryland, USA. erashba@medicine.umaryland.edu

Journal of Cardiovascular Electrophysiology
|October 3, 2003
PubMed
Summary

Placing the right ventricular (RV) coil in a distal position significantly lowers defibrillation thresholds (DFTs). This finding suggests optimizing RV coil placement can improve defibrillation efficacy and lead design.

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Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Defibrillation thresholds (DFTs) are critical for defibrillation efficacy and transvenous lead design.
  • Factors influencing DFTs require further understanding for improved device performance.

Purpose of the Study:

  • To prospectively evaluate if a distal right ventricular (RV) coil position improves defibrillation efficacy compared to a proximal RV coil position.

Main Methods:

  • A novel defibrillation lead with three RV coils was used to compare proximal and distal coil configurations.
  • Defibrillation thresholds were measured twice in each patient using a binary search protocol, randomizing configuration order.
  • 31 subjects (mean age 65 years, LVEF 30%) were included in the study.

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Main Results:

  • The distal RV coil configuration resulted in significantly lower mean delivered energy (8.2 J vs 11.2 J), voltage (335 V vs 393 V), and peak current (11.6 A vs 14.9 A) at DFT compared to the proximal configuration (P < 0.01).

Conclusions:

  • A distal RV coil configuration significantly reduces defibrillation thresholds (DFTs).
  • Future defibrillation lead designs should aim for minimal tip-to-coil distance while maintaining sensing capabilities.