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Related Experiment Videos

A patch in the pectoral position lowers defibrillation threshold

P Karasik1, A Solomon, R Verdino

  • 1Department of Cardiology, VA Medical Center 20422, USA.

Pacing and Clinical Electrophysiology : PACE
|June 1, 1997
PubMed
Summary
This summary is machine-generated.

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Adding a pectoral subcutaneous patch significantly reduces high defibrillation thresholds (DFTs) in patients with implantable pacemaker cardioverter defibrillators. This simple method ensures successful implantation with an adequate safety margin.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Implantable pacemaker cardioverter defibrillators (ICDs) utilize biphasic waveforms to improve defibrillation thresholds (DFTs).
  • High DFTs persist in some patients, and DFT can increase post-implantation, particularly with antiarrhythmic drug use.

Purpose of the Study:

  • To evaluate the efficacy of a pectoral subcutaneous patch in reducing DFT in patients receiving transvenous ICDs.
  • To assess the impact of this technique on system impedance and ensure successful ICD implantation with a safety margin.

Main Methods:

  • A 660-mm2 patch electrode was implanted subcutaneously in the pectoral position, beneath the ICD generator pocket.
  • Fifteen patients with transvenous defibrillators underwent this procedure.

Related Experiment Videos

  • Defibrillation energy requirements and system impedance were measured before and after patch placement.

    • Main Results:

    • The pectoral patch significantly reduced the energy required for defibrillation by an average of 56%.
    • Mean system impedance decreased by 25% following the addition of the subcutaneous patch.
    • All 15 patients achieved successful ICD implantation with an adequate safety margin.

    Conclusions:

    • A pectoral subcutaneous patch is an effective and easily implemented method for reducing DFT in ICD patients.
    • This technique improves the safety margin for defibrillation, facilitating successful ICD implantation.
    • The reduction in system impedance may also contribute to improved ICD performance.