Randomized Comparison of a 90 uF Capacitor Three-electrode Defibrillation System with a 125 uF Two-electrode Defibrillation System

Marwan Bahu, Bradley P. Knight, Raul Weiss, Stephen J. Hahn, Rajiva Goyal, Emile G. Daoud, K. Ching Man, Fred Morady, S. Adam Strickberger*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction: A variety of factors, including the number of defibrillation electrodes and shocking capacitance, may influence the defibrillation efficacy of an implantable defibrillator system. Therefore, the purpose of this study was to compare the defibrillation energy requirement using a 125 uF two-electrode defibrillation system and a 90 uF three-electrode defibrillation system. Methods and Results: The defibrillation energy requirements measured with both systems were compared in 26 consecutive patients. The two-electrode system used a single transvenous lead with two defibrillation coils in conjunction with a biphasic waveform from a 125 uF capacitor. The three-electrode system used the same transvenous lead, utilized a pectoral implantable defibrillator generator shell as a third electrode, and delivered the identical biphasic waveform from a 90 uF capacitor. The two-electrode system was associated with a higher defibrillation energy requirement (10.8±5.5 J) than was the three-electrode system (8.9±6.7 J, p < 0.05), however, the leading edge voltage was not significantly different between systems (361±103 V vs. 397±123 V, P = 0.07). The two-electrode system also had a higher shocking resistance (49.0±9.0 ohms vs. 41.4±7.3 ohms, p < 0.001) and a lower peak current (7.7±2.6 A vs. 10.1±3.7 A, p < 0.001) than the three-electrode system. Conclusions: A three-electrode defibrillation system that utilizes a dual coil transvenous lead and a subcutaneous pectoral electrode with lower capacitance is associated with a lower defibrillation energy requirement than is a dual coil defibrillation system with higher capacitance. This finding suggests that the utilization of a pectoral generator as a defibrillation electrode in conjunction with smaller capacitors is a more effective defibrillation system and may allow for additional miniaturization of implantable defibrillators.

Original languageEnglish (US)
Pages (from-to)41-45
Number of pages5
JournalJournal of Interventional Cardiac Electrophysiology
Volume2
Issue number1
DOIs
StatePublished - Jan 1 1997

Keywords

  • Defibrillation energy requirement
  • Defibrillation threshold
  • Implantable cardioverter-defibrillator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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