Implantable cardioverter-defibrillator patch shunting effect manifestations on the body surface map

The purpose of this study was to demonstrate the known shunting effect of implantable cardioverter-defibrillator patches using the body surface map. Using a 32-lead body surface mapping computer system (Corazonix Predictor, Oklahoma City, OK) we recorded body surface potential maps both prior to and 7 days after implantable cardioverter-defibrillator patch placement in a patient during right ventricular pacing at 60 beats/minute. This study demonstrated a marked shunting effect from the patches to the body surface during electrical depolarization as well as repolarization. In addition, patch orientation and configuration were evaluated by this method. Specifically, the waveforms were affected by the presence of insulator patches. This may be an important explanation, which may prevent appropriate transthoracic defibrillation using standard configurations. Further research is necessary to elucidate the true effect of the depolarization and repolarization waveform and defibrillator patches.