What question did this study set out to answer?

March 1, 1994CirculationOpen Access

Prospective, randomized comparison in humans of a unipolar defibrillation system with that using an additional superior vena cava electrode.

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Why the study?

Does adding a superior vena cava electrode to a unipolar defibrillation system improve defibrillation threshold in cardiac arrest survivors undergoing ICD implantation?

Population

15 consecutive cardiac arrest survivors undergoing implantation of a transvenous defibrillation system

Comparison

Three-electrode dual pathway defibrillation… vs Simplified unipolar defibrillation system using…

Design

RCT, prospectively and randomly compared

Authors

GBGust H. BardyElectrophysiology GDG. Lee DolackUniversity of Washington PKPeter J. KudenchukElectrophysiology

Discussion

Member takes

Implication

DFT unchanged by SVC electrode addition; challenges benefit of dual-pathway over single-lead unipolar transvenous ICD systems.

Key Points

To determine whether adding a superior vena cava electrode to a unipolar transvenous defibrillation system improves defibrillation efficacy.
Prospectively and randomly evaluated 15 consecutive cardiac arrest survivors undergoing transvenous defibrillator implantation.
Compared a single-lead unipolar system (RV-->CAN) against a three-electrode dual-pathway configuration (RV-->SVC + CAN) using a 65% tilt asymmetric biphasic waveform.
Stored energy defibrillation threshold did not differ significantly between the RV-->CAN system (7.4 ± 5.2 J) and the RV-->SVC + CAN system (6.0 ± 3.4 J, P = .20).
Pulsing resistance was significantly lower with the three-electrode system (48.6 ± 3.5 Ω vs 61.2 ± 5.9 Ω, P < .0001), alongside a non-significant rise in delivered current (6.3 ± 1.8 A vs 5.5 ± 2.0 A, P = .062).

Structured PICO

Does adding a superior vena cava electrode to a unipolar defibrillation system improve defibrillation threshold in cardiac arrest survivors undergoing ICD implantation?

Population

15 consecutive cardiac arrest survivors undergoing implantation of a transvenous defibrillation system

Intervention

Three-electrode dual pathway defibrillation system incorporating a high superior vena cava (SVC) electrode (RV-->SVC + CAN)

Comparator

Simplified unipolar defibrillation system using a single right ventricular (RV) electrode and the active shell (CAN) (RV-->CAN)

Outcome

Defibrillation threshold (DFT) stored energysurrogate

Adding a superior vena cava electrode to a unipolar transvenous defibrillation system increases complexity without significantly improving defibrillation energy thresholds.

Cite This Study

Bardy et al. (1994) studied this question.

synapsesocial.com/papers/6a70a0a0f44fa9f079de4e7f https://doi.org/10.1161/01.cir.89.3.1090

Topics

Ventricular arrhythmias Cardiac device therapy

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Prospective, randomized comparison in humans of a unipolar defibrillation system with that using an additional superior vena cava electrode.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Prospective, randomized comparison in humans of a unipolar defibrillation system with that using an additional superior vena cava electrode.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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