Atrial Defibrillation Thresholds of Electrode Configurations Available to an Atrioventricular Defibrillator

Abstract

The atrial defibrillation threshold of CS-->SVC+Can is significantly lower than that of RV-->SVC+Can. In addition, the low atrial defibrillation threshold of RV+CS-->SVC+Can merits further investigation. Based on corroboration of low atrial defibrillation thresholds of CS-based configurations in humans, physicians might consider using CS leads with atrioventricular defibrillators.

Evaluation of a Dual Chamber Implantable Cardioverter Defibrillator for the Treatment of Atrial and Ventricular Arrhythmias

“…The study shows that the addition of a shocking electrode within the CS may allow conversion of atrial tachyarrhythmia/AF with low energies. The net advantage of this lead configuration has been demonstrated in animal studies, 8 though human data are limited 9 . Insertion of the CS lead did not prolong the ICD implant procedure.…”

Transmural characteristics of atrial fibrillation in canine models of structural and electrical atrial remodeling assessed by simultaneous epicardial and endocardial mapping

“…In 6 of the Control animals, methylcholine at 1 g/250 ml saline IV11 was infused until a 20-mmHg decrease in the blood pressure and a 20% decrease in heart rate or spontaneous AF was observed. Once the blood pressure stabilized, the mapping protocol was performed.…”

Optimization of Atrial Defibrillation with a Dual‐Coil, Active Pectoral Lead System

“…Atrial defibrillation efficacy is influenced by many factors, such as the shocking lead configuration and the defibrillation waveform 13,14 , 17,18 . In animal studies, defibrillation efficacy was maximized with biphasic waveforms and lead configurations that incorporated a CS electrode 19 . Because the CS is positioned posteriorly near the left atrium, it makes intuitive sense that a CS electrode would lower atrial DFTs.…”