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Effect of the Superior Vena Cava Electrode Surface Area on Defibrillation Threshold in Different Lead Systems
Author(s) -
TOMASSONI GERY,
NEWBY KEITH,
MOREDOCK LYNN,
REMBERT JUDY,
NATALE ANDREA
Publication year - 1998
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.1540-8159.1998.tb01066.x
Subject(s) - medicine , defibrillation threshold , defibrillation , lead (geology) , superior vena cava , cardiology , electrode , chemistry , geomorphology , geology
Little data is available comparing the efficacy of the Transvene, Endotak C 70 series, and the active CAN configuration on defibrillation success. In addition, the impact of the superior vena cava (SVC) electrode surface area and length on the active CAN system is unknown. Therefore, we compared the defibrillation efficacy of the Transvene and Endotak C 70 series lead systems with and without the active CAN in dogs. Defibrillation threshold (DFT) testing was randomly performed in 20 dogs. In protocol I [10 dogs), DFT energy was compared in three BV/SVC lead systems with an SVC electrode defibrillating surface area of 90 mm 2 (Transvene‐90), 160 mni 2 (Transvene‐160). 617 mm 2 (En‐dotak), and an RV/CAN configuration. In protocol II (10 dogs), DFT comparison was performed in the Transvene‐90/CAN, Transvene‐160/CAN. Endotak/CAN, and RV/CAN configurations. In protocol I, in‐creasing the SVC surface area from 90 to 160 mm 2 and from 160 to 617 mm 2 significantly lowered DFT energy. The Endotak and the RV/CAN systems provided the lowest DET energy requirements. In protocol II, the Endotak/CAN system significantly lowered DFT energy compared to the other three lead configu‐rations. In both protocols, the impedance decreased as the SVC surface area increased from 90 to 160 mm 2 . However, no significant reduction in DFT impedance occurred as the SVC surface area increased from the Transvene‐160 to the Endotak lead. Increasing the SVC surface area from 90 to 617 mm 2 in a two coil lead system lowered DFT energy to similar levels provided by the HV/CAN configuration. The addition of an SVC electrode with a surface area of 90 or 160 mm 2 did not reduce DFT energy compared to the RV/CAN configuration. The Endotak/CAN system, however, provided the lowest DFT requirements.