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Effect of electrode length on atrial defibrillation thresholds
C Timmermans1, L M Rodriguez, G M Ayers
1Department of Cardiology, Academic Hospital Maastricht, The Netherlands. C.Timmermans@cardio.azm.nl
Journal of Cardiovascular Electrophysiology
|July 8, 1998
Summary
Longer electrode lengths for atrial defibrillation did not reduce energy requirements. However, increasing electrode length significantly lowered shock impedance in patients undergoing cardioversion.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Catheter-based electrodes are used for terminating atrial fibrillation.
- Optimal energy is achieved with electrodes in the distal coronary sinus and right atrium.
- Previous electrodes spanned 6-7 cm.
Purpose of the Study:
- To evaluate the efficacy of longer electrode lengths for atrial defibrillation.
- To determine if longer electrodes reduce energy requirements for restoring sinus rhythm.
Main Methods:
- Fifteen patients received two decapolar catheters (distal coronary sinus and right atrium).
- A third catheter was added to create longer electrode spans (6 cm to 11 cm).
- Atrial defibrillation thresholds were measured using randomized electrode combinations.
Main Results:
- All patients were successfully converted to sinus rhythm.
- No significant differences in defibrillation voltage or energy were observed with longer electrodes (P > 0.05).
- Longer electrode lengths significantly reduced shock impedance (P < 0.05).
Conclusions:
- Using longer electrodes (up to 11 cm) with a right atrium to coronary sinus vector does not lower defibrillation energy requirements.
- Longer electrodes may offer benefits by reducing impedance during atrial defibrillation.