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Europace Advance Access published online on January 11, 2006
Europace, doi:10.1093/europace/euj034
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© The European Society of Cardiology 2006. All rights reserved
Received December 3, 2004
Accepted October 18, 2005

Article

Passive electrode effect reduces defibrillation threshold in bi-filament middle cardiac vein defibrillation

John R. Paisey 1 *, Arthur M. Yue 2, Frederick Bessoule 3, Paul R. Roberts 2, and John M. Morgan 2

1 Wessex Cardiothoracic Centre, Southampton University Hospitals, Southampton, UK; Mail Point 46, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
2 Wessex Cardiothoracic Centre, Southampton University Hospitals, Southampton, UK
3 Ela Medical SA, Paris, France

* To whom correspondence should be addressed.
John R. Paisey, E-mail: johnpaisey{at}doctors.org.uk


  Abstract

Aims To investigate whether a passive electrode effect decreases defibrillation threshold (DFT) in multi-filament middle cardiac vein (MCV) defibrillation.

Methods and results Twelve pigs underwent active housing (AH) insertion, with defibrillation coils placed transvenously in right ventricular apex and superior vena cava. The MCV was cannulated, and 1.12F, 50 mm coil electrodes (Ela Medical SA, France) were deployed in its right and left branches. Lead placement was possible in 11 of 12 animals. DFT (J, mean ± SD) was determined by three-reversal binary search and compared between the MCV monofilament (single filament deployed) and the AH (25.9 ± 10.9) and the MCV mono + passive filaments (both filaments deployed, one connected) and the AH (19.9 ± 11.4); 24% DFT reduction P = 0.008.

Conclusion A bystander electrode adjacent to a monofilament electrode in the MCV reduces DFT by 24% when compared with monofilament MCV alone. Microfilament electrodes decrease DFT as auxiliary anode but not as sole anode.

Keywords: Defibrillation threshold; Passive electrode; Cardiac vein; Bystander electrode; Implantable defibrillator.
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