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September 1, 1986CirculationOpen Access

The mean ratio of the highest to the lowest measured gradient over the entire ventricular epicardium was 19.4 +/- 8.1 SD for the RA.V combination and 14.4 +/- 3.4 for the RV.LV combination, with earliest activation sites after unsuccessful shocks located in areas of weak potential gradient.

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Why the study?

Does the potential gradient field distribution determine where shocks fail to halt fibrillation in a canine model?

Population

Six open-chest dogs

Comparison

1 to 2 V shocks and high-voltage shocks just… vs Comparison between RA.V and RV.LV electrode…

Design

Preclinical

Authors

PCP S ChenPWPatrick D. WolfFCF.J. Claydon

Discussion

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Overview

May explain shock failure sites via weak gradients in canines; leaves open optimal electrode configurations for clinical defibrillation.

Structured PICO

Does the potential gradient field distribution determine where shocks fail to halt fibrillation in a canine model?

P
Population
Six open-chest dogs
I
Intervention
1 to 2 V shocks and high-voltage shocks just below the defibrillation threshold delivered through epicardial defibrillation electrodes on the right atrium and left ventricular apex (RA.V) and on the right and left ventricles (RV.LV)
C
Comparator
Comparison between RA.V and RV.LV electrode combinations
O
Outcome
Potential gradient field across the ventricles and ventricular activation patterns after unsuccessful shockssurrogate

The potential gradient field for epicardial defibrillation electrodes is markedly uneven, and areas with weak gradients are the earliest sites of activation after unsuccessful shocks, suggesting electrode locations should be optimized to improve defibrillation.

Cite This Study

Chen et al. (1986) studied this question.

synapsesocial.com/papers/6a70c74935aa2c282ce217dehttps://doi.org/10.1161/01.cir.74.3.626
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiac potential and potential gradient fields generated by single, combined, and sequential shocks during ventricular defibrillation.1992 · 132 citations
  2. 2Three-dimensional potential gradient fields generated by intracardiac catheter and cutaneous patch electrodes.1992 · 92 citations
  3. 3Epicardial mapping of ventricular defibrillation with monophasic and biphasic shocks in dogs.1993 · 164 citations
  4. 4A Percutaneous Catheter‐Based System for the Measurement of Potential Gradients Applicable to the Study of Transthoracic Defibrillation2007 · 6 citations
  5. 5Conduction disturbances caused by high current density electric fields.1990 · 156 citations