Literature DB >> 9093040

Does reducing capacitance have potential for further miniaturisation of implantable defibrillators?

E Alt1, F Evans, P D Wolf, J Pasquantonio, L Stotts, S Heinz, A Schömig.   

Abstract

OBJECTIVE: To determine whether considerably smaller capacitors could replace 125 microF capacitors as the standard for use in implantable defibrillators.
METHODS: Measured energy, impedance, voltage, and current delivered were compared at defibrillation threshold in 10 mongrel dogs for defibrillation using 75 microF and 125 microF capacitors alternated randomly. Defibrillation was attempted with biphasic shocks of comparable tilt between an endocardial lead in the right ventricular apex and a "dummy" active can of an experimental implantable device placed in the subpectoral position.
RESULTS: A reduction of capacitor size of 40% was associated with an increase in voltage of 21% and in current of 22%. With a 65% tilt, no significant differences were found between the two capacitances with respect to the impedance or energy required for defibrillation.
CONCLUSIONS: Multiple advances in electrode material, electrode configuration, shock morphology, and shock polarity have reduced defibrillation energy requirements. Smaller capacitors could be used in implantable cardioverter/defibrillators without a major decrease in effectiveness.

Entities:  

Mesh:

Year:  1997        PMID: 9093040      PMCID: PMC484688          DOI: 10.1136/hrt.77.3.234

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


  14 in total

Review 1.  Current concepts for selecting the location, size and shape of defibrillation electrodes.

Authors:  R E Ideker; P D Wolf; C Alferness; W Krassowska; W M Smith
Journal:  Pacing Clin Electrophysiol       Date:  1991-02       Impact factor: 1.976

2.  Defibrillation with low voltage using a left ventricular catheter and four cutaneous patch electrodes in dogs.

Authors:  P A Guse; K M Kavanagh; C A Alferness; P D Wolf; D Rollins; J Hagler; W M Smith; R E Ideker
Journal:  Pacing Clin Electrophysiol       Date:  1991-03       Impact factor: 1.976

3.  Comparison of the internal defibrillation thresholds for monophasic and double and single capacitor biphasic waveforms.

Authors:  K M Kavanagh; A S Tang; D L Rollins; W M Smith; R E Ideker
Journal:  J Am Coll Cardiol       Date:  1989-11-01       Impact factor: 24.094

4.  Ventricular defibrillation using biphasic waveforms: the importance of phasic duration.

Authors:  A S Tang; S Yabe; J M Wharton; M Dolker; W M Smith; R E Ideker
Journal:  J Am Coll Cardiol       Date:  1989-01       Impact factor: 24.094

5.  Effect of capacitor size and pathway resistance on defibrillation threshold for implantable defibrillators.

Authors:  C D Swerdlow; R M Kass; P S Chen; C Hwang; S Raissi
Journal:  Circulation       Date:  1994-10       Impact factor: 29.690

6.  Prospective, randomized comparison in humans of a unipolar defibrillation system with that using an additional superior vena cava electrode.

Authors:  G H Bardy; G L Dolack; P J Kudenchuk; J E Poole; R Mehra; G Johnson
Journal:  Circulation       Date:  1994-03       Impact factor: 29.690

7.  Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings.

Authors:  M Mirowski; P R Reid; M M Mower; L Watkins; V L Gott; J F Schauble; A Langer; M S Heilman; S A Kolenik; R E Fischell; M L Weisfeldt
Journal:  N Engl J Med       Date:  1980-08-07       Impact factor: 91.245

8.  Response of relatively refractory canine myocardium to monophasic and biphasic shocks.

Authors:  J P Daubert; D W Frazier; P D Wolf; M R Franz; W M Smith; R E Ideker
Journal:  Circulation       Date:  1991-12       Impact factor: 29.690

9.  Influence of implantable cardioverter-defibrillators on the long-term prognosis of survivors of out-of-hospital cardiac arrest.

Authors:  A C Powell; T Fuchs; D M Finkelstein; H Garan; D S Cannom; B A McGovern; E Kelly; G J Vlahakes; D F Torchiana; J N Ruskin
Journal:  Circulation       Date:  1993-09       Impact factor: 29.690

10.  Defibrillation thresholds are lower with smaller storage capacitors.

Authors:  F M Leonelli; M W Kroll; J E Brewer
Journal:  Pacing Clin Electrophysiol       Date:  1995-09       Impact factor: 1.976

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