Intracavitary electrode catheter cardioversion of atrial tachyarrhythmias in the dog
| Autor: | Joseph Fetter, David G. Benditt, D. Woodrow Benson, David Dunbar, Charles C. Gornick, H. Gareth Tobler |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
Cardiac Catheterization medicine.medical_treatment Electric Countershock Cardioversion QRS complex Electrocardiography Dogs Internal medicine Medicine Animals Sinus rhythm Heart Atria cardiovascular diseases Atrium (heart) Electrodes business.industry Atrial fibrillation Arrhythmias Cardiac medicine.disease medicine.anatomical_structure Anesthesia Ventricular fibrillation Cardiology cardiovascular system Venae cavae business Cardiology and Cardiovascular Medicine Atrioventricular block |
| Zdroj: | Journal of the American College of Cardiology. (5):1015-1027 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/S0735-1097(86)80219-4 |
| Popis: | This study examined factors determining efficacy of intracavitary cardioversion of atrial tachyarrhythmias in closed chest, anesthetized dogs with talc pericarditis. Electrode catheters were positioned transvenously with the cathode in the right atrial appendage. In Group 1 dogs (n = 6), three anode sites (superior and inferior venae cavae ostia and mid-right atrium) were tested with graded energy shocks to determine the lowest effective cardioversion energy at each anode position. In Group 2 dogs (n = 9), multiple cardioversion attempts with energy levels of 0.01 to 5.0 J were used to evaluate reproducibility of energy thresholds. In Group 3 dogs (n = 6) without talc-induced pericarditis, atrial pathologic study was done after five intracavitary shocks (0.5 or 5.0 J). In Group 1, cardioversion was achieved with 0.75 J or less with no significant difference in minimal effective cardioversion energies among the three anode positions tested. In Group 2, 98 (26%) of 372 cardioversion attempts were successful. Intra-animal minimal effective cardioversion energies varied widely, and timing of shocks relative to atrial electrograms did not influence efficacy. Complications were infrequent and included delayed sinus rhythm recovery, transient atrioventricular block and ventricular fibrillation. Ventricular fibrillation occurred in 9 (2.4%) of 372 shocks, and was associated with higher delivered energies (6 of 9 with greater than or equal to 1.0 J) and with shocks delivered 116 to 180 ms after onset of the QRS complex. In Group 3, two dogs had no histologic damage, three dogs had multiple small foci of subendocardial necrosis and in one dog these foci coalesced to involve half the atrial wall thickness. Thus, low energy cardioversion of atrial tachyarrhythmias is feasible using intracavitary electrodes. Synchronization of energy delivery to the QRS complex is important to minimize risk of ventricular fibrillation. |
| Databáze: | OpenAIRE |
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