UNLABELLED: Defibrillation energy requirements of epicardial implantable cardioverter defibrillator systems are generally lower than endovascular systems currently used. The former has the disadvantage of requiring a thoracotomy and so has a greater morbidity and mortality than an endovascular procedure. The middle cardiac vein (MCV) is an epicardial structure that is accessible by a non-thoracotomy approach. This study investigated the merits of ventricular defibrillation from the middle cardiac vein. METHODS AND RESULTS. Defibrillation thresholds (DFT) were measured in 10 anesthetized pigs, weighing 34.5 +/- 44.1 kg (mean 39 kg). An Angeflex electrode (1.7 mm x 50 mm) was introduced via the left external jugular vein to the right ventricular apex. The MCV was identified with standard angiography techniques and a 4080 (Angeion Corp.) defibrillation electrode (1.6 mm x 65 mm) introduced into the vein. An active can was implanted in the left subpectoral region. The defibrillation thresholds (DFT) of the following defibrillation configurations were assessed using a modified four-reversal binary search: RV-->Can, RV + MCV-->Can and MCV-->Can. The DFT's for the three configurations were 15.5 +/- 2.8 J, 10.8 +/- 3.4 J and 13.7 +/- 2.4 J. Analysis of variance showed that the DFT with the RV + MCV combination was significantly less than the RV alone (p < 0.05) CONCLUSIONS: Defibrillation is possible through the MCV and that incorporating an electrode in the MCV with RV-Can configuration can reduce the DFT by 30%.
UNLABELLED: Defibrillation energy requirements of epicardial implantable cardioverter defibrillator systems are generally lower than endovascular systems currently used. The former has the disadvantage of requiring a thoracotomy and so has a greater morbidity and mortality than an endovascular procedure. The middle cardiac vein (MCV) is an epicardial structure that is accessible by a non-thoracotomy approach. This study investigated the merits of ventricular defibrillation from the middle cardiac vein. METHODS AND RESULTS. Defibrillation thresholds (DFT) were measured in 10 anesthetized pigs, weighing 34.5 +/- 44.1 kg (mean 39 kg). An Angeflex electrode (1.7 mm x 50 mm) was introduced via the left external jugular vein to the right ventricular apex. The MCV was identified with standard angiography techniques and a 4080 (Angeion Corp.) defibrillation electrode (1.6 mm x 65 mm) introduced into the vein. An active can was implanted in the left subpectoral region. The defibrillation thresholds (DFT) of the following defibrillation configurations were assessed using a modified four-reversal binary search: RV-->Can, RV + MCV-->Can and MCV-->Can. The DFT's for the three configurations were 15.5 +/- 2.8 J, 10.8 +/- 3.4 J and 13.7 +/- 2.4 J. Analysis of variance showed that the DFT with the RV + MCV combination was significantly less than the RV alone (p < 0.05) CONCLUSIONS: Defibrillation is possible through the MCV and that incorporating an electrode in the MCV with RV-Can configuration can reduce the DFT by 30%.
Authors: P R Roberts; Y Zhang; S Zhuan; K A Mowrey; D W Wallick; D G Hills; T R Betts; S Allen; J Ewert; T N Mazgalev; J M Morgan Journal: J Interv Card Electrophysiol Date: 2001-12 Impact factor: 1.900
Authors: P R Roberts; S Allen; T Betts; J F Urban; D E Euler; S Crick; R H Anderson; M J Kallok; J M Morgan Journal: Heart Date: 2000-10 Impact factor: 5.994
Authors: Zhongwei Cheng; Mintu Turakhia; Ronald Lo; Anurag Gupta; Paul C Zei; Henry H Hsia; Amin Al-Ahmad; Paul J Wang Journal: J Interv Card Electrophysiol Date: 2012-03-06 Impact factor: 1.900
Authors: P R Roberts; J R Paisey; T R Betts; S Allen; T Whitman; M Bonner; J M Morgan Journal: J Interv Card Electrophysiol Date: 2003-02 Impact factor: 1.900