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Right atrial septal electrode for reducing the atrial defibrillation threshold. 2001

X Zheng, and M E Benser, and G P Walcott, and R E Ideker
Division of Cardiovascular Diseases, Department of Medicine, University of Alabama, Birmingham, USA.

BACKGROUND The atrial defibrillation threshold (ADFT) energy of the standard lead configuration, right atrial appendage (RAA) to coronary sinus (CS), was reduced by >50% with the addition of a third electrode traversing the atrial septum in a previous study. This study determined whether the ADFT would be lowered by a more clinically practical third electrode placed in the right atrium along the atrial septum (RSP). RESULTS Sustained atrial fibrillation was induced in 8 closed-chest sheep with burst pacing and maintained with pericardial infusion of acetyl-beta-methylcholine chloride. A custom-made, dual-defibrillation catheter was placed with electrodes in the lateral RA, CS, and RSP. A separate defibrillation catheter was also placed in the RAA. ADFT characteristics of RAA-->CS and 6 other single- or sequential-shock configurations were determined in random order by using biphasic, truncated-exponential waveforms in a multiple-reversal protocol. The delivered-energy, peak-voltage, and peak-current ADFTs for the sequential-shock configuration CS-->RSP/RA-->RSP (0.53+/-0.31 J, 86+/-22 V, and 1.6+/-0.6 A, respectively) were significantly lower than those of RAA-->CS (1.14+/-0.64 J, 157+/-34 V, and 2.5+/-1.1 A, respectively). The ADFT characteristics of RAA-->CS and RA-->CS were not significantly different, nor were those of CS-->RSP/RA-->RSP and CS-->RSP/RAA--> RSP. CONCLUSIONS The ADFT of the standard RAA-->CS configuration may be markedly reduced with an additional electrode situated at the RSP.

UI MeSH Term Description Entries
D004567 Electrodes, Implanted Surgically placed electric conductors through which ELECTRIC STIMULATION is delivered to or electrical activity is recorded from a specific point inside the body. Implantable Electrodes,Implantable Stimulation Electrodes,Implanted Electrodes,Implanted Stimulation Electrodes,Electrode, Implantable,Electrode, Implantable Stimulation,Electrode, Implanted,Electrode, Implanted Stimulation,Electrodes, Implantable,Electrodes, Implantable Stimulation,Electrodes, Implanted Stimulation,Implantable Electrode,Implantable Stimulation Electrode,Implanted Electrode,Implanted Stimulation Electrode,Stimulation Electrode, Implantable,Stimulation Electrode, Implanted,Stimulation Electrodes, Implantable,Stimulation Electrodes, Implanted
D006325 Heart Atria The chambers of the heart, to which the BLOOD returns from the circulation. Heart Atrium,Left Atrium,Right Atrium,Atria, Heart,Atrium, Heart,Atrium, Left,Atrium, Right
D006346 Heart Septum This structure includes the thin muscular atrial septum between the two HEART ATRIA, and the thick muscular ventricular septum between the two HEART VENTRICLES. Cardiac Septum,Heart Septa,Septa, Heart,Septum, Cardiac,Septum, Heart
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001281 Atrial Fibrillation Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation. Auricular Fibrillation,Familial Atrial Fibrillation,Paroxysmal Atrial Fibrillation,Persistent Atrial Fibrillation,Atrial Fibrillation, Familial,Atrial Fibrillation, Paroxysmal,Atrial Fibrillation, Persistent,Atrial Fibrillations,Atrial Fibrillations, Familial,Atrial Fibrillations, Paroxysmal,Atrial Fibrillations, Persistent,Auricular Fibrillations,Familial Atrial Fibrillations,Fibrillation, Atrial,Fibrillation, Auricular,Fibrillation, Familial Atrial,Fibrillation, Paroxysmal Atrial,Fibrillation, Persistent Atrial,Fibrillations, Atrial,Fibrillations, Auricular,Fibrillations, Familial Atrial,Fibrillations, Paroxysmal Atrial,Fibrillations, Persistent Atrial,Paroxysmal Atrial Fibrillations,Persistent Atrial Fibrillations
D012684 Sensory Thresholds The minimum amount of stimulus energy necessary to elicit a sensory response. Sensory Threshold,Threshold, Sensory,Thresholds, Sensory
D012756 Sheep Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS. Ovis,Sheep, Dall,Dall Sheep,Ovis dalli
D017147 Defibrillators, Implantable Implantable devices which continuously monitor the electrical activity of the heart and automatically detect and terminate ventricular tachycardia (TACHYCARDIA, VENTRICULAR) and VENTRICULAR FIBRILLATION. They consist of an impulse generator, batteries, and electrodes. Cardioverter-Defibrillators, Implantable,Implantable Cardioverter Defibrillator,Implantable Cardioverter-Defibrillators,Implantable Defibrillators,Cardioverter Defibrillator, Implantable,Cardioverter Defibrillators, Implantable,Cardioverter-Defibrillator, Implantable,Defibrillator, Implantable,Defibrillator, Implantable Cardioverter,Defibrillators, Implantable Cardioverter,Implantable Cardioverter Defibrillators,Implantable Cardioverter-Defibrillator,Implantable Defibrillator
D022062 Electrophysiologic Techniques, Cardiac Methods to induce and measure electrical activities at specific sites in the heart to diagnose and treat problems with the heart's electrical system. Cardiac Electrophysiologic Techniques,Electrophysiologic Study, Cardiac,Atrial Electrogram,Bundle of His Electrogram,Cardiac Electrophysiologic Technics,Cardiac Electrophysiological Techniques,Electrophysiologic Techniques, Intracardiac,Electrophysiological Techniques, Cardiac,Electrophysiological Techniques, Intracardiac,His Bundle Electrogram,Intra-Atrial Electrogram,Intracardiac Electrogram,Intracardiac Electrophysiologic Techniques,Intracardiac Electrophysiological Technics,Intracardiac Electrophysiological Techniques,Programmed Electrostimulation, Cardiac,Transesophageal Electrophysiologic Study,Transesophageal Electrophysiological Study,Atrial Electrograms,Bundle Electrogram, His,Bundle Electrograms, His,Cardiac Electrophysiologic Studies,Cardiac Electrophysiologic Study,Cardiac Electrophysiologic Technic,Cardiac Electrophysiologic Technique,Cardiac Electrophysiological Technique,Cardiac Programmed Electrostimulation,Cardiac Programmed Electrostimulations,Electrogram Bundle, His,Electrogram Bundles, His,Electrogram, Atrial,Electrogram, His Bundle,Electrogram, Intra-Atrial,Electrogram, Intracardiac,Electrograms, Atrial,Electrograms, His Bundle,Electrograms, Intra-Atrial,Electrograms, Intracardiac,Electrophysiologic Studies, Cardiac,Electrophysiologic Studies, Transesophageal,Electrophysiologic Study, Transesophageal,Electrophysiologic Technic, Cardiac,Electrophysiologic Technics, Cardiac,Electrophysiologic Technique, Cardiac,Electrophysiologic Technique, Intracardiac,Electrophysiological Studies, Transesophageal,Electrophysiological Study, Transesophageal,Electrophysiological Technic, Intracardiac,Electrophysiological Technics, Intracardiac,Electrophysiological Technique, Cardiac,Electrophysiological Technique, Intracardiac,Electrostimulation, Cardiac Programmed,Electrostimulations, Cardiac Programmed,His Bundle Electrograms,His Electrogram Bundle,His Electrogram Bundles,Intra Atrial Electrogram,Intra-Atrial Electrograms,Intracardiac Electrograms,Intracardiac Electrophysiologic Technique,Intracardiac Electrophysiological Technic,Intracardiac Electrophysiological Technique,Programmed Electrostimulations, Cardiac,Studies, Cardiac Electrophysiologic,Studies, Transesophageal Electrophysiologic,Studies, Transesophageal Electrophysiological,Study, Cardiac Electrophysiologic,Study, Transesophageal Electrophysiologic,Study, Transesophageal Electrophysiological,Technic, Cardiac Electrophysiologic,Technic, Intracardiac Electrophysiological,Technics, Cardiac Electrophysiologic,Technics, Intracardiac Electrophysiological,Technique, Cardiac Electrophysiologic,Technique, Cardiac Electrophysiological,Technique, Intracardiac Electrophysiologic,Technique, Intracardiac Electrophysiological,Techniques, Cardiac Electrophysiologic,Techniques, Cardiac Electrophysiological,Techniques, Intracardiac Electrophysiologic,Techniques, Intracardiac Electrophysiological,Transesophageal Electrophysiologic Studies,Transesophageal Electrophysiological Studies

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