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Related Experiment Videos

Sequential pulse countershock between two transvenous catheters: feasibility, safety, and efficacy.

R Yee1, D L Jones, G J Klein

  • 1Cardiac Investigation Unit, University Hospital, London, Ontario, Canada.

Pacing and Clinical Electrophysiology : PACE
|December 1, 1989
PubMed
Summary

Sequential pulse countershock (SqCS) delivered via endocardial catheters is a feasible and effective method for terminating ventricular tachycardia (VT) and fibrillation (VF) during electrophysiology studies (EPS). This approach uses energy levels comparable to implantable cardioverter defibrillators.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening arrhythmias.
  • Current defibrillation methods often require transthoracic shocks.
  • Endocardial catheter-based therapies are advancing in cardiac electrophysiology.

Purpose of the Study:

  • To evaluate the feasibility, safety, and efficacy of sequential pulse countershock (SqCS) delivered solely through endocardial catheters.
  • To assess SqCS for terminating induced VT and VF during electrophysiology studies (EPS).

Main Methods:

  • SqCS was delivered using two endocardial catheters positioned in the right ventricular apex (RVA) and coronary sinus (CS).
  • The RVA electrode served as the cathode, with anodes positioned in the right atrium/superior vena cava and distal CS.

Related Experiment Videos

  • Thirty-four patients undergoing EPS with induced VT/VF were studied.

    • Main Results:

    • SqCS successfully terminated 15 of 29 VT episodes; 14 accelerated or degenerated to VF.
    • Successful VT termination by SqCS was associated with longer cycle lengths (CL) compared to accelerated episodes (285 vs. 245 ms).
    • SqCS terminated 21 of 26 VF episodes; 5 required transthoracic rescue shocks. No complications were reported.

    Conclusions:

    • Sequential pulse countershock (SqCS) delivered exclusively via endocardial catheters is feasible and effective for terminating VT and VF.
    • The energy doses used are within the range of current implantable cardioverter defibrillators.
    • This catheter-based approach offers a potential alternative for defibrillation during electrophysiology procedures.