Decreased Defibrillation Threshold and Minimized Myocardial Damage With Left Axilla Implantable Cardioverter Defibrillator Implantation
| Autor: | Masako Asami, Tsuyoshi Sakai, Haruhiko Abe, Takao Sakata, Shingo Kujime, Rina Ishii, Hikari Hashimoto, Keijirou Nakamura, Yasutake Toyoda, Hiroyuki Tatsunami, Mahito Noro, Yasuhiro Oikawa, Yuriko Narabayashi, Takahito Takagi, Naohiko Sahara, Yoshinari Enomoto, Naoshi Ito, Kaoru Sugi, Xin Zhu |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Defibrillation medicine.medical_treatment Implantation Site Electric Countershock 030204 cardiovascular system & hematology Defibrillation threshold 03 medical and health sciences 0302 clinical medicine Anterior chest Internal medicine medicine Humans Computer Simulation 030212 general & internal medicine Aged Aged 80 and over business.industry Myocardium Models Cardiovascular General Medicine Middle Aged medicine.disease Implantable cardioverter-defibrillator Defibrillators Implantable Axilla medicine.anatomical_structure Shock (circulatory) Ventricular fibrillation Ventricular Fibrillation Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 80(4) |
| ISSN: | 1347-4820 |
| Popis: | BACKGROUND To reduce myocardial damage caused by implantable cardioverter defibrillator (ICD) shock, the left axilla was studied as an alternative pulse generator implantation site, and compared with the traditional implantation site, the left anterior chest. METHODS AND RESULTS Computer simulation was used to study the defibrillation conduction pattern and estimate the simulated defibrillation threshold (DFT) and myocardial damage when pulse generators were placed in the left axilla and left anterior chest, respectively; pulse generators were also newly implanted in the left axilla (n=30) and anterior chest (n=40) to compare the corresponding DFT. On simulation, when ICD generators were implanted in the left axilla, compared with the left anterior chest, the whole heart may be defibrillated with a lower defibrillation energy (left axilla 6.4 J vs. left anterior chest 12.0 J) and thus the proportion of cardiac myocardial damage may be reduced (2.1 vs. 4.2%). Clinically, ventricular fibrillation was successfully terminated with a defibrillation output ≤5 J in 86.7% (26/30) of the left axillary group, and in 27.5% (11/40) of the left anterior group (P |
| Databáze: | OpenAIRE |
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