Early changes in defibrillation threshold following implantation of a nonthoracotomy system in dogs

B. D. Halperin, Daniel (Dan) Haupt, J. H. Lemmer, S. R. Holcomb, R. P. Oliver, M. J. Silka

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Nonthoracotomy systems are rapidly becoming the preferred surgical method for implantation of cardioverter defibrillators. Testing is performed at the time of implantation to insure an adequate margin of safety for defibrillation. However, this safety margin may change with lead maturation. This study evaluated changes in defibrillation threshold following implantation of a nonthoracotomy system. Methods and Results: Ten dogs underwent implantation of a nonthoracotomy system consisting of a single catheter with a distal coil electrode in the right ventricular apex and a proximal coil electrode in the superior vena cava forming a common anode with a subcutaneous patch over the left thorax. Defibrillation threshold testing, using a biphasic waveform, was performed on each animal under general anesthesia at implantation (day 1) and subsequently on postoperative days 3, 7, 10, 17, 24, 31, 38, and 45, E50, the energy associated with a 50% likelihood of successful defibrillation, was determined at each setting. The mean E50 was 12.2 ± 1.1 J at the time of implantation, increasing 36% to 16.8 ± 2.0 J by day 38 (P <0.01). Individual increases in E50 of 10-12 J were observed in four animals. Conclusions: Energy requirements for defibrillation with a nonthoracotomy system increase during the early postoperative period, with the highest defibrillation threshold observed at 38 days. This increase may be applicable to humans and should be considered when selecting an adequate energy safety margin for defibrillation at time of implantation.

Original languageEnglish (US)
Pages (from-to)1771-1777
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume17
Issue number11 I
DOIs
StatePublished - 1994

Fingerprint

Electrodes
Dogs
Safety
Superior Vena Cava
Defibrillators
Postoperative Period
General Anesthesia
Thorax
Catheters
Lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Early changes in defibrillation threshold following implantation of a nonthoracotomy system in dogs. / Halperin, B. D.; Haupt, Daniel (Dan); Lemmer, J. H.; Holcomb, S. R.; Oliver, R. P.; Silka, M. J.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 17, No. 11 I, 1994, p. 1771-1777.

Research output: Contribution to journalArticle

Halperin, B. D. ; Haupt, Daniel (Dan) ; Lemmer, J. H. ; Holcomb, S. R. ; Oliver, R. P. ; Silka, M. J. / Early changes in defibrillation threshold following implantation of a nonthoracotomy system in dogs. In: PACE - Pacing and Clinical Electrophysiology. 1994 ; Vol. 17, No. 11 I. pp. 1771-1777.
@article{290b97802f174b67b65d8a5cd7478338,
title = "Early changes in defibrillation threshold following implantation of a nonthoracotomy system in dogs",
abstract = "Background: Nonthoracotomy systems are rapidly becoming the preferred surgical method for implantation of cardioverter defibrillators. Testing is performed at the time of implantation to insure an adequate margin of safety for defibrillation. However, this safety margin may change with lead maturation. This study evaluated changes in defibrillation threshold following implantation of a nonthoracotomy system. Methods and Results: Ten dogs underwent implantation of a nonthoracotomy system consisting of a single catheter with a distal coil electrode in the right ventricular apex and a proximal coil electrode in the superior vena cava forming a common anode with a subcutaneous patch over the left thorax. Defibrillation threshold testing, using a biphasic waveform, was performed on each animal under general anesthesia at implantation (day 1) and subsequently on postoperative days 3, 7, 10, 17, 24, 31, 38, and 45, E50, the energy associated with a 50{\%} likelihood of successful defibrillation, was determined at each setting. The mean E50 was 12.2 ± 1.1 J at the time of implantation, increasing 36{\%} to 16.8 ± 2.0 J by day 38 (P <0.01). Individual increases in E50 of 10-12 J were observed in four animals. Conclusions: Energy requirements for defibrillation with a nonthoracotomy system increase during the early postoperative period, with the highest defibrillation threshold observed at 38 days. This increase may be applicable to humans and should be considered when selecting an adequate energy safety margin for defibrillation at time of implantation.",
author = "Halperin, {B. D.} and Haupt, {Daniel (Dan)} and Lemmer, {J. H.} and Holcomb, {S. R.} and Oliver, {R. P.} and Silka, {M. J.}",
year = "1994",
doi = "10.1111/j.1540-8159.1994.tb03744.x",
language = "English (US)",
volume = "17",
pages = "1771--1777",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "11 I",

}

TY - JOUR

T1 - Early changes in defibrillation threshold following implantation of a nonthoracotomy system in dogs

AU - Halperin, B. D.

AU - Haupt, Daniel (Dan)

AU - Lemmer, J. H.

AU - Holcomb, S. R.

AU - Oliver, R. P.

AU - Silka, M. J.

PY - 1994

Y1 - 1994

N2 - Background: Nonthoracotomy systems are rapidly becoming the preferred surgical method for implantation of cardioverter defibrillators. Testing is performed at the time of implantation to insure an adequate margin of safety for defibrillation. However, this safety margin may change with lead maturation. This study evaluated changes in defibrillation threshold following implantation of a nonthoracotomy system. Methods and Results: Ten dogs underwent implantation of a nonthoracotomy system consisting of a single catheter with a distal coil electrode in the right ventricular apex and a proximal coil electrode in the superior vena cava forming a common anode with a subcutaneous patch over the left thorax. Defibrillation threshold testing, using a biphasic waveform, was performed on each animal under general anesthesia at implantation (day 1) and subsequently on postoperative days 3, 7, 10, 17, 24, 31, 38, and 45, E50, the energy associated with a 50% likelihood of successful defibrillation, was determined at each setting. The mean E50 was 12.2 ± 1.1 J at the time of implantation, increasing 36% to 16.8 ± 2.0 J by day 38 (P <0.01). Individual increases in E50 of 10-12 J were observed in four animals. Conclusions: Energy requirements for defibrillation with a nonthoracotomy system increase during the early postoperative period, with the highest defibrillation threshold observed at 38 days. This increase may be applicable to humans and should be considered when selecting an adequate energy safety margin for defibrillation at time of implantation.

AB - Background: Nonthoracotomy systems are rapidly becoming the preferred surgical method for implantation of cardioverter defibrillators. Testing is performed at the time of implantation to insure an adequate margin of safety for defibrillation. However, this safety margin may change with lead maturation. This study evaluated changes in defibrillation threshold following implantation of a nonthoracotomy system. Methods and Results: Ten dogs underwent implantation of a nonthoracotomy system consisting of a single catheter with a distal coil electrode in the right ventricular apex and a proximal coil electrode in the superior vena cava forming a common anode with a subcutaneous patch over the left thorax. Defibrillation threshold testing, using a biphasic waveform, was performed on each animal under general anesthesia at implantation (day 1) and subsequently on postoperative days 3, 7, 10, 17, 24, 31, 38, and 45, E50, the energy associated with a 50% likelihood of successful defibrillation, was determined at each setting. The mean E50 was 12.2 ± 1.1 J at the time of implantation, increasing 36% to 16.8 ± 2.0 J by day 38 (P <0.01). Individual increases in E50 of 10-12 J were observed in four animals. Conclusions: Energy requirements for defibrillation with a nonthoracotomy system increase during the early postoperative period, with the highest defibrillation threshold observed at 38 days. This increase may be applicable to humans and should be considered when selecting an adequate energy safety margin for defibrillation at time of implantation.

UR - http://www.scopus.com/inward/record.url?scp=0028075879&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028075879&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8159.1994.tb03744.x

DO - 10.1111/j.1540-8159.1994.tb03744.x

M3 - Article

C2 - 7838785

AN - SCOPUS:0028075879

VL - 17

SP - 1771

EP - 1777

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 11 I

ER -