Key result
Reverse shock polarity significantly reduced mean biphasic defibrillation thresholds compared to normal polarity (7.2 +/- 4.6 J vs 8.5 +/- 5.0 J, P=0.02).
Why the study?
Does reverse shock polarity reduce biphasic defibrillation thresholds in patients undergoing active left pectoral defibrillator implantation?
Population
60 consecutive patients undergoing dual-coil, active left pectoral defibrillator implantation
Comparison
Reverse polarity biphasic defibrillation testing vs Normal polarity biphasic defibrillation testing
Design
RCT, order of testing randomized
Authors
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Reverse polarity warrants consideration to minimize energy needs during active pectoral ICD implantation; extends RCT data on polarity optimization.
RCT (n=60)
Randomized order of testing
Does reverse shock polarity reduce biphasic defibrillation thresholds in patients undergoing active left pectoral defibrillator implantation?
Effect estimate: 15% reduction
Absolute Event Rate: 7.2% vs 8.5%
p-value: p=0.02
Reversing shock polarity to RV apex anode significantly lowers biphasic defibrillation thresholds during active pectoral lead system implantation, particularly in patients with high normal polarity thresholds.
Olsovsky et al. (1998) conducted an RCT in Patients undergoing dual-coil, active left pectoral defibrillator implantation (n=60). Reverse shock polarity (RV apex = anode) vs. Normal shock polarity (RV apex = cathode) was evaluated on Mean biphasic defibrillation thresholds (DFTs) (15% reduction, p=0.02). Reverse shock polarity significantly reduced mean biphasic defibrillation thresholds compared to normal polarity (7.2 +/- 4.6 J vs 8.5 +/- 5.0 J, P=0.02).
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