Key result
Pectoral subcutaneous patch placement linked to ~56% lower defibrillation energy requirements.
Why the study?
Does a subcutaneous patch in the pectoral position reduce defibrillation threshold in patients receiving a transvenous defibrillator?
Case Report (n=15)
Does a subcutaneous patch in the pectoral position reduce defibrillation threshold in patients receiving a transvenous defibrillator?
Adding a subcutaneous patch electrode in the pectoral position effectively lowers defibrillation thresholds and system impedance in patients receiving transvenous defibrillators.
Implantable pacemaker cardioverter defibrillators are now available with biphasic waveforms, which have been shown to markedly improve defibrillation thresholds (DFTs). However, in a number of patients the DFT remains high. Also, DFT may increase after implantation, especially if antiarrhythmic drugs are added. We report on the use of a subcutaneous patch in the pectoral position in 15 patients receiving a transvenous defibrillator as a method of easily reducing the DFT. A 660-mm2 patch electrode was placed beneath the generator in a pocket created on the pectoral fascia. The energy required for defibrillation was lowered by 56% on average, and the system impedance was lowered by a mean of 25%. This maneuver allowed all patients to undergo a successful implant with adequate safety margin.
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Karasik et al. (1997) conducted a case report in High defibrillation threshold in patients receiving a transvenous defibrillator (n=15). Subcutaneous patch in the pectoral position was evaluated on Energy required for defibrillation and system impedance. Placement of a subcutaneous patch in the pectoral position lowered the energy required for defibrillation by an average of 56% and system impedance by a mean of 25%.
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