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Postshock Sensing Performance in Transvenous Defibrillation Lead Systems : Analysis of Detection and Redetection of Ventricular Fibrillation
Author(s) -
CALLANS DAVID J.,
SWARNA UDAYA S.,
SCHWARTZMAN DAVID,
GOTTLIEB CHARLES D.,
MARCHLINSKI FRANCIS E.
Publication year - 1995
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1995.tb00436.x
Subject(s) - cadence , medicine , ventricular fibrillation , shock (circulatory) , cardiology , defibrillation , lead (geology) , atrial fibrillation , defibrillation threshold , physical medicine and rehabilitation , geomorphology , geology
Postshock Sensing in Transvenous Lead Systems. Introduction : The sensing performance of transvenous lead systems may be adversely affected by the delivery of high‐energy shocks. This may be due to the proximity of the sensing and energy‐delivery electrodes on transvenous leads. Methods and Results : The time required for detection of ventricular fibrillation and redetection after a failed first shock was compared in 93 patients with five different lead system‐pulse generator combinations: Cadence TM ‐ Endotak TM 60 series, Ventak P TM ‐ Endotak TM 60 series, Jewel TM ‐ Transvene TM , Cadence TM ‐ TVL TM , and Cadence TM ‐ Transvene TM . A total of 418 successful and 204 failed first shocks were delivered during induced ventricular fibrillation. Redetection times (RED) were consistently shorter than detection times (DET) in the Jewel‐Transvene (RED minus DET: 1.9 ± 0.8 sec, P < 0.0001), the Cadence‐TVL (‐1.6 ± l.0sec, P < 0.0001), and the Cadence‐Transvene combinations (‐2.0 ± 0.9 sec, P < 0.0004). Redetection times were not significantly different than detection times in the Cadence‐Endotak combination (‐0.9 ± 3.1 sec; P = 0.09). Redetection times were significantly longer than detection times in the Ventak‐Endotak combination (1.2 ± 2.3 sec; P = 0.034). Prolonged individual redetection episodes (> 8.2 sec) were observed in the Cadence‐Endotak (7 [10%] of 73 episodes) and the Ventak‐Endotak (4 [10%] of 39 episodes), but not in the Jewel‐Transvene, the Cadence‐TVL, and the Cadence‐Transvene combinations. Conclusions : Redetection of ventricular fibrillation may be delayed in some transvenous lead‐pulse generator combinations. Successful redetection of ventricular fibrillation following a failed first shock should be demonstrated prior to hospital discharge of patients with implantable defibrillators.