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Related Experiment Videos

Endocardial pacing, cardioversion and defibrillation using a braided endocardial lead system

S Saksena1, R Luceri, R B Krol

  • 1Arrhythmia and Pacemaker Service, Eastern Heart Institute, Passaic, New Jersey 07055.

The American Journal of Cardiology
|April 1, 1993
PubMed
Summary

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Biphasic shocks effectively terminate ventricular tachycardia (VT) and ventricular fibrillation (VF) using a novel lead system. This system demonstrated superior efficacy and lower energy requirements compared to monophasic shocks for treating these life-threatening arrhythmias.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening arrhythmias requiring prompt treatment.
  • Traditional defibrillation systems face challenges in efficacy and energy delivery.
  • Second-generation braided endocardial lead systems offer potential improvements in managing these conditions.

Purpose of the Study:

  • To evaluate the clinical efficacy and safety of a novel second-generation braided endocardial pacing, cardioversion, and defibrillation lead system.
  • To compare the effectiveness of monophasic versus biphasic shocks in terminating VT and VF.
  • To assess the impact of shock delivery on ventricular pacing thresholds and electrogram amplitudes.

Main Methods:

  • A prospective study involving 25 patients with VT or VF.

Related Experiment Videos

  • Utilized a triple-electrode configuration including two 8Fr active fixation endocardial leads and a thoracic patch electrode.
  • Delivered monophasic and biphasic shocks to electrically induce and treat VT and VF episodes.

    • Main Results:

    • Biphasic shocks terminated 94% of VF episodes at ≤20 J, significantly outperforming monophasic shocks (53%).
    • For rapid VT/VF, biphasic shocks achieved 92% efficacy at a lower average energy (15 J) compared to monophasic shocks (74% at 19 J).
    • No significant changes were observed in ventricular pacing thresholds or electrogram amplitudes post-shock delivery.

    Conclusions:

    • The evaluated second-generation braided endocardial lead system is clinically effective and safe for managing VT and VF.
    • Biphasic waveform shocks demonstrate superior efficacy and energy efficiency compared to monophasic shocks for defibrillation.
    • This lead system represents a promising advancement in implantable cardioverter-defibrillator technology.