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European Heart Journal 1988 9(1):92-101;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Bidirectional transvenous/subcutaneous defibrillation of ventricular fibrillation in dogs: success rates, energy requirements, currents, voltages and impedance

T. BUDDE*,, N. B. VUKMIROVIC{dagger}, J.-M. SORIANO-ROMERO{dagger}, S. ABU-GHAZALEH{dagger}, M. BORGGREFE*,, F.K. SCHMIEL*, B. POLITZ*, G. ARNOLD{dagger} and G. BREITHARDT*

*Medical Hospital of the University of Düsseldorf, Department of Cardiology, Pneumology and Angiology F.R.G.
{dagger}Department of Experimental Surgery, University of Dusseldorf, Düsseldorf F.R.G.

Address for correspondence: Dr med. Th. Budde, Abteilung fur Kardiologie, Pneumologie und Angiologie der Universität. Moorenstr 5. D-4000 Dusseldorf, F.R.G.

Abstract

Four hundred and thirteen defibrillations of alternating current-induced ventricular fibrillation were performed in 10 halothane-anaesthetized dogs (body weight: 24.5–30.5 kg). Success rates, energy demands, currents, peak voltages and impedance were determined. A transvenous catheter electrode system (Medtronic 6880, right ventricular apex and superior vena cava, distance 100 or 150 mm) and subcutaneous patch electrodes (Intec 67 L, 2nd/3rd and/or 3rd/4th left intercostal space) were used for bidirectional defibrillation. Loading voltages ranged from 600 to 850 V. With an electrode distance of 100 mm and a pulse duration of 2 ms separated by 1 ms, success rates were 100%, 40% and 0% for 850, 650 and 600 V, respectively. With a 3-ms pulse duration, the corresponding rates were 100%, 60% and 50%. With a 2-ms pulse duration, successful defibrillation was achieved with energies lower than 15 J in 27%, with energies between 15 and 20 J in 77%, and 100% with energies higher than 20 J. Defibrillation currents were 4.4–9.3 A for pulse 1 (superior vena cava/ventricular apex) and 6.3–13.4 A for pulse 2 (patch/ventricular apex), respectively. Effective peak voltages ranged from 510 to 787 V and from 514 to 777 V and averaged 89.6% of the loading voltages. Impedance values (peak voltage/current) were 75.5–117.7 (pulse 1) and 51.7–94.9 Ohms (pulse 2). Fifty consecutive defibrillations in one animal resulted in a decrease of impedance (114.6 to 84.9 Ohms, pulse 1; 75.4 to 53.0 Ohms, pulse 2). Defibrillation of ventricular fibrillation can be achieved with acceptably low energies using a bidirectional transvenous/subcutaneous system, avoiding thoracotomy and general anaesthesia for implantation of the defibrillation system.

Key Words: Transvenous • subcutaneous defibrillation • bidirectional defibrillation • ventricular fibrillation • subcutaneous patch electrodes


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