An Experimental Study of Transvenous Defibrillation Using a Coronary Sinus Catheter
Key result
A three-electrode right atrium and coronary sinus common cathode reduces defibrillation energy ~21% versus control.
- P<0.01
- n=14
Why the study?
Does a transvenous defibrillating system utilizing a coronary sinus catheter reduce defibrillation energy thresholds in normal mongrel dogs?
Population
14 normal mongrel dogs
Comparison
Transvenous defibrillation using a coronary… vs Transvenous defibrillation using the proximal…
Design
Preclinical
Authors
Discussion
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Implication
Hypothesis-generating in canine models; leaves open whether coronary sinus cathodes improve human ICD defibrillation thresholds or outcomes.
Structured PICO
Does a transvenous defibrillating system utilizing a coronary sinus catheter reduce defibrillation energy thresholds in normal mongrel dogs?
P
Population
14 normal mongrel dogs evaluated for transvenous defibrillation using bipolar right ventricular and coronary sinus catheters.
I
Intervention
Transvenous defibrillation using a coronary sinus cathode (configuration B) or a common cathode of superior vena cava and coronary sinus electrodes (configuration C)
C
Comparator
Transvenous defibrillation using the proximal pole of the right ventricular catheter (superior vena cava) as the cathode (configuration A)
O
Outcome
Mean energy at which 50% or more of the shocks were successfulsurrogate
Main Result
Absolute Event Rate: 21.4% vs 27.1%
p-value: p=<0.01
A three-electrode transvenous defibrillation system utilizing the coronary sinus and superior vena cava as a common cathode significantly reduces defibrillation energy thresholds in a canine model.
Cite This Study
Kadish et al. (1989) studied this question. Three-electrode system with high right atrium and coronary sinus as common cathode (Configuration C) vs. Superior vena cava to right ventricular apex system (Configuration A) was evaluated on Mean defibrillation energy at which 50% or more of the shocks were successful (joules) (p=<0.01). A three-electrode system with the high right atrium and coronary sinus serving as the common cathode reduced mean defibrillation energy compared to control (21.4 vs 27.1 joules; P<0.01).