Reduction of Atrial Defibrillation Threshold With an Interatrial Septal Electrode
| Autor: | Xiangsheng Zheng, Gregory P. Walcott, Steven D. Girouard, Michael E. Benser, Dennis L. Rollins, William M. Smith, Raymond E. Ideker |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Defibrillation medicine.medical_treatment Electric Countershock Muscarinic Agonists Defibrillation threshold Electrocardiography Heart Rate Physiology (medical) Internal medicine medicine.artery Atrial Fibrillation Heart Septum medicine Animals Methacholine Chloride Coronary sinus Sheep Atrium (architecture) business.industry Cardiac Pacing Artificial Reproducibility of Results Heart Signal Processing Computer-Assisted Atrial fibrillation medicine.disease Atrial septum Electrodes Implanted Energy Transfer Sensory Thresholds Electrode Pulmonary artery Cardiology Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 102:2659-2664 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.102.21.2659 |
| Popis: | Background —The standard lead configuration for internal atrial defibrillation consists of a shock between electrodes in the right atrial appendage (RAA) and coronary sinus (CS). We tested the hypothesis that the atrial defibrillation threshold (ADFT) of this RAA→CS configuration would be lowered with use of an additional electrode at the atrial septum (SP). Methods and Results —Sustained atrial fibrillation was induced in 8 closed-chest sheep with burst pacing and continuous pericardial infusion of acetyl-β-methylcholine. Defibrillation electrodes were situated in the RAA, CS, pulmonary artery (PA), low right atrium (LRA), and across the SP. ADFTs of RAA→CS and 4 other lead configurations were determined in random order by use of a multiple-reversal protocol. Biphasic waveforms of 3/1-ms duration were used for all single and sequential shocks. The ADFT delivered energies for the single-shock configurations were 1.27±0.67 J for RAA→CS and 0.86±0.59 J for RAA+CS→SP; the ADFTs for the sequential-shock configurations were 0.39±0.18 J for RAA→SP/CS→SP, 1.16±0.72 J for CS→SP/RAA→SP, and 0.68±0.46 J for RAA→CS/LRA→PA. Except for CS→SP/RAA→SP versus RAA→CS and RAA→CS/LRA→PA versus RAA+CS→SP, the ADFT delivered energies of all of the configurations were significantly different from each other ( P Conclusions —The ADFT of the standard RAA→CS configuration is markedly reduced with an additional electrode at the atrial SP. |
| Databáze: | OpenAIRE |
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