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• W2067072379 abstract "Objectives. The purpose of this study was to conduct a retrospective analysis of 16 patients with high initial defibrillation thresholds in whom a three-electrode system was used to lower defibrillation threshold and permit implantation of a cardioverter-defibrillator system. Background. Patients with high defibrillation thresholds(>25 J) are uncommon but may be problematic to physicians implementing cardioverter-defibrillator systems. Most conventional systems use two defibrillating electrodes, most commonly two epicardial patches. When defibrillatation threshold remain elevated despite extensive testing of a two-electrode system, a third electrode can be incorporated and tested. However, few published data exist on the use of a three-electrode system in patients with high defibrillation thresholds. Methods. After failure to achieve satisfactory defibrillation thresholds <25 J with a two-patch electrode system, a third electrode was incorporated and tested. in all cases, two electrodes were joined to form a common cathode or anode, while a single electrode was used as the opposite polarity electrode. Various three-electrode configurations were then tested. Results. In all 16 patients, satisfactory defibrillation thresholds were achieved and a cardioverter-defibrillator was implanted (95% confidence interval [CI] = 0% to 21%). The mean final defibrillation threshold using the revised three-electrode system was 19.5 ± 3.7 J (p < 0.0001). A mean of 6 ± 3 electrode configurations/patient were tested before the final configuration was selected. A total of nine different electrode configurations were used in the 16 study patients; the most common of these incorporated left and right ventricular patches as combined cathode and a superior vena cava coil (n = 5) or right atrial patch electrode (n = 3) as single anode. Conclusion. Patients with high initial defibrillation thresholds can generally undergo successful cardioverter-defibrillator implantation with a tnree-electrode system if enough electrode configurations are tested after a third electrode is incorporated." @default.
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• W2067072379 date "1993-08-01" @default.
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• W2067072379 title "Successful implantation of cardiovascular-defibrillator systems in patients with elevated defibrillation thresholds" @default.
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• W2067072379 doi "https://doi.org/10.1016/0735-1097(93)90066-a" @default.
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