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

Abstract

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.

Incidence and clinical predictors of low defibrillation safety margin at time of implantable defibrillator implantation

“…A distal shock coil far from apex may elevate DFTs [41,42], and implanting the RV lead near septum and apex may lower DFTs [43][44][45]. Adding a shock coil in the middle cardiac vein [46][47][48][49][50] or azygous vein or implanting a subcutaneous array electrode [51][52][53][54] may be a more successful strategy for low DSM patients who failed to convert ventricular fibrillation with maximum delivered energy, especially in right-sided implant patients. The extra shock coil and subcutaneous array can substantially improve the shocking vector or waveform to obtain an adequate DSM.…”