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Bipolar Transvenous Defibrillation: Efficacy of Two Different Positions of the Anode
Author(s) -
BLOCK MICHAEL,
HAMMEL DIETER,
BÖCKER DIRK,
BORGGREFE MARTIN,
BUDDE THOMAS,
CASTRUCCI MARCO,
FASTENRATH CHRISTIAN,
SCHELD HANS H.,
BREITHARDT GUNTER
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.tb03859.x
Subject(s) - defibrillation , defibrillation threshold , medicine , cardiology , position (finance) , finance , economics
For most nonthoracotomy defibrillotion lead systems, the transvenous anode can be positioned independently of the right ventricular (RV) cathode. Usually a vertical position in the superior vena cava (SVC) is chosen. However, it is unknown if this position yields the optimal defibrillation threshold (DFT). There‐fort, in 15 patients undergoing defibrillator implantation the SVC position was compared in a crossover study design with a horizontal position in the left brachiocephalic vein (BCV). Mean DFT was not different for SVC and BCV (19.2 ± 9.6) vs 18.5 ± 9.1 J) but DFT of individual patients differed by up to 12 joules. A positive correlation between impedance and DFT in the BCV position (r = 0.6; P ≤ 0.05) indicated that the improved geometry of the defibrillation field with the BCV position is opposed by a higher impedance found for this position (63 ± 15 Ω vs 52 ± 7 Ω). Thus, defibrillation is not improved in general although individual patients might benefit.