Biventricular shocking leads improve defibrillation efficacy

Yoshio Yamanouchi*, Igor R. Efimov, Kent A. Mowrey, Todor N. Mazgalev, Bruce L. Wilkoff, Patrick J. Tchou

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction: A single lead active can configuration has been widely used in patients with life-threatening ventricular arrhythmias. Occasionally, however, such a defibrillation lead configuration may not achieve adequate defibrillation threshold (DFT). The purpose of this study was to determine whether addition of a left ventricular (LV) lead can improve defibrillation efficacy. Methods and Results: Three transvenous defibrillation leads (8.3- French with a 5-cm long unipolar coil) were placed in the right ventricle (RV), LV, and superior vena cava (SVC), along with an active can (92 cm2) in the left subpectoral area. The DFT stored energy of seven combinations of these defibrillation leads were compared in a pig ventricular fibrillation model using a biphasic defibrillation waveform (125 μF, 6.5/3.5 msec). A biventricular leads active can configuration in which the RV and LV leads were of the same polarity reduced the DFT stored energy by approximately 35% when compared to a single RV lead active can configuration (9.6 ± 3.0 J vs 15.0 ± 7.2 J, respectively, P = 0.02). Moreover, adding a SVC lead further reduced the DFT energy (8.4 ± 3.3 J). Conclusion: A biventricular leads active can configuration can significantly improve defibrillation efficacy as compared to a single lead active can configuration. In such a defibrillation lead configuration, the polarity of RV and LV leads should be the same.

Original languageEnglish (US)
Pages (from-to)561-565
Number of pages5
JournalJournal of cardiovascular electrophysiology
Issue number4
StatePublished - 1999


  • Biventricular leads
  • Defibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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