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A Long Thin Electrode Is Equivalent to a Short Thick Electrode for Defibrillation in the Right Ventricle
Author(s) -
LEONELLI FABIO M.,
WRIGHT HART,
LATTERELL SCOTT T.,
NELSON RANDALL S.,
ADAMS TED P.,
KROLL MARK W.
Publication year - 1995
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.1540-8159.1995.tb02508.x
Subject(s) - defibrillation , medicine , electrode , defibrillation threshold , lead (geology) , ventricle , ventricular fibrillation , cardiology , biomedical engineering , chemistry , geomorphology , geology
We hypothesized that a long thin right ventricular (RV) electrode would have equivalent defibrillation threshold (DFT) performance to a short thick electrode with approximately the same surface area. This could lead to thinner transvenous lead systems, which would be easier to implant. A thin (5.1 French) lead was compared to a standard control (10.7 French). The thin lead had an 8‐cm RV electrode length with a surface area of 4.26 cm 2 . The standard lead had a RV electrode length of 3.7 cm and a surface area of 4.12 cm 2 . A 140‐μFrench capacitor 65%/65% tilt biphasic defibrillation shock was delivered between the RV electrode and a 14‐cm 2 subcutaneous patch. DFTs were determined following 10 seconds of fibrillation in 11 dogs by a triple determination averaging technique. The thin lead had a lower resistance (77.1 ± 27.4 Ω vs 88.9 ± 30.3 Ω, P < 0.001) than did the thick lead. There was no significant difference in stored energy DFTs (9.9 ± 2.5 vs 10.3 ± 2.7, P = 0.098 2‐sided, P = 0.049 1‐sided). This was in spite of the fact that the long thin lead had a portion of its RV coil extending above the tricuspid valve and, thus, not contributing efficiently to the ventricular gradients in the small dog heart. We conclude that a long thin right ventricular electrode and a standard short thick electrode had equivalent defibrillation performance. This preliminary result should be confirmed in clinical studies as it could lead to significantly thinner transvenous lead systems.