Premium
Implantable Defibrillator Electrode Systems: A Brief Review
Author(s) -
SANTEL DONALD J.,
KALLOK MICHAEL J.,
TACKER WILLIS A.
Publication year - 1985
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1985.tb05731.x
Subject(s) - defibrillation , medicine , electrode , ventricular fibrillation , intracardiac injection , catheter , cardiology , ventricle , superior vena cava , biomedical engineering , surgery , chemistry
Since the first report of a defibrillation attempt with an intracurdiac catheter electrode nearly 30 years ago, investigators have developed implantable electrode systems consisting of metal disks, endocardial catheters, and epicardial patches. These early efforts demonstrated the feasibility of low‐energy reversion of ventricular tachyarrhythmias, and also provided some in sight into the mechanisms of fibrillation and defibrillation. This review describes the evolution of implantable defibrillator electrode systems. Early investigators attempted defibrillation with submuscularly implanted metal disks or a disk electrode paired with an endocardiul catheler electrode. Electrode design emphasis turned to transvenous catheter systems with electrodes placed in the right ventricle and right atrium. A more successful configuration placed the proximal electrode in the superior vena cava. In an effort to ensure proper placement of the distal electrode in humans, the catheter was replaced with an epicardial patch. More recently, a combination of electrodes and multiple pulses has substantially reduced the energy required to defibrillate. Effective electrode systems that can convert lethal arrhythmias with a minimum of energy will aid in making implantable cardioverters and defibrillators the therapy of choice in patients at high risk of sudden coronary death.