Comparison of titanium-mesh and porous disc electrodes for epicardial defibrillation.

The object of this study was to compare the effectiveness of chronically implanted porous electrodes with that of smooth mesh titanium electrodes of the same diameter but smaller effective surface area. The criteria used in evaluating the electrodes were (1) acute, subacute, and chronic resistance and (2) acute, subacute, and chronic defibrillation thresholds. Electrode pairs 2.5 cm in diameter were implanted in each of 17 dogs (ten mesh and seven porous). One electrode of each pair was sutured to the right ventricle and one to the left ventricle near the cardiac apex. Defibrillation threshold energy and total resistance were measured at the time of implantation and again 6 and 12 weeks after implantation. The mean initial resistance of the titanium electrodes was 131.7 omega; the mean defibrillation values for the porous electrode implant were 96.9 omega and 7.5 joules, respectively. Three to 6 weeks after implantation, the values for the titanium mesh electrode were 88.9 omega and 12.0 joules, while those for the porous electrode were 59.9 omega and 8.0 joules. In the chronic state, the figures for the titanium mesh electrode were 78.1 omega and 13.0 joules, while those for the porous electrode were 64.3 omega and 8.3 joules. We conclude that defibrillation can be achieved successfully with small epicardial electrodes. The findings suggest that a porous electrode, with its larger effective surface area, has lower electrode/tissue interface resistance in the acute and chronic phases, and, therefore, provides lower defibrillation threshold energy.