[Morphophysiological aspects of closed destruction of the conduction pathways of the heart].

An experimental study in an electrophysiological model of the human body showed defibrillator discharge current, used for closed electrodestruction of His' bundle in cases of drug-resistant supraventricular tachycardias, to cause a spark discharge and high-energy shock wave around the intracardiac electrode resulting in contusion of the heart. To stop the sparking, it is suggested that impulse voltage should be reduced while its duration should be prolonged in order to maintain local destruction potential. The relationship between the damaging effect of the impulse, and its force and duration was examined so that optimum action parameters could be established.

[Clinical use of transvenous electrodestruction of the atrioventricular junction in patients with supraventricular tachyarrhythmia].

The authors described 51 patients with different types of supraventricular tachyarrhythmias and ciliary arrhythmia paroxysms who showed resistance to drug therapy. All the patients were treated by the closed transvenous electrodestruction of the atrioventricular junction by producing a series of discharges with a defibrillator to the area of His' bundle, the power being 280-400 J. A stable and complete transversal blockade was obtained in 45 patients, in 6 patients the restoration of permeability in the atrioventricular system with frequent ventricular responses was observed, being the reason for repeated electrodestructions.