What is the clinical evidence from this study?

Population: Defibrillation threshold modeling. Intervention: Different electrode placements. Primary outcome: Defibrillation threshold (energy required to produce a potential gradient of at least 5 V/cm in 95% of the ventricular myocardium).

What does this research mean for the field?

Defibrillation thresholds vary significantly by electrode placement in a human thorax model, with the RV to SVC plus Can configuration achieving the lowest energy requirement (6 J) and RVprox to SVC the highest (16 J), closely matching clinical measurements. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

January 1, 1999Pacing and Clinical Electrophysiology

Defibrillation Efficacy of Different Electrode Placements in a Human Thorax Model

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Key result

RV->SVC + Can achieves the lowest defibrillation threshold of 6 Joules in a computer model.

Why the study?

Does electrode placement affect the defibrillation threshold in a human thorax finite element model?

Population

Three-dimensional anatomically realistic finite element model of the human thorax

Comparison

Five electrode configurations (RV-->SVC, RVprox-->SVC, RVseptal-->SVC, RV-->Can, and RV-->SVC + Can)

Design

Computational finite element simulation study

Authors

AJA.L. de JonghRhodes College EEEmilia EntchevaGeorge Washington University JRJ.A. ReplogleUniversity of Memphis

Discussion

Member takes

Implication

Model-derived thresholds vary by configuration; leaves open whether findings guide clinical lead selection or require prospective validation.

Structured PICO

Does electrode placement affect the defibrillation threshold in a human thorax finite element model?

Population

A three-dimensional anatomically realistic finite element model of the human thorax used to measure defibrillation thresholds for five electrode configurations.

Exposure

Five electrode configurations: RV-->SVC, RVprox-->SVC, RVseptal-->SVC, RV-->Can, and RV-->SVC + Can using coil electrodes (Endotak DSP, model 125) and an active pulse generator (can) in the subcutaneous prepectoral space

Comparator

Comparison among the five different electrode configurations

Outcome

Defibrillation threshold (DFT), defined as the energy required to produce a potential gradient of at least 5 V/cm in 95% of the ventricular myocardiumsurrogate

A computational human thorax model successfully simulated defibrillation thresholds for various electrode configurations, yielding results consistent with clinical studies.

Cite This Study

Jongh et al. (1999) studied Defibrillation threshold modeling. Different electrode placements was evaluated on Defibrillation threshold (energy required to produce a potential gradient of at least 5 V/cm in 95% of the ventricular myocardium). In a human thorax computer model, defibrillation thresholds for RV->SVC, RVprox->SVC, RVseptal->SVC, RV->Can, and RV->SVC + Can configurations were 10, 16, 7, 9, and 6 J, respectively.

synapsesocial.com/papers/6aa8bf0ad792cb2664807c20 https://doi.org/10.1111/j.1540-8159.1999.tb00323.x

Topics

Ventricular arrhythmias Cardiac device therapy

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Implication

Model-derived thresholds vary by configuration; leaves open whether findings guide clinical lead selection or require prospective validation.

Defibrillation Efficacy of Different Electrode Placements in a Human Thorax Model

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Topics

Defibrillation Efficacy of Different Electrode Placements in a Human Thorax Model

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Topics

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