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Low-energy defibrillation using a base-apex epicardial electrode. | LitMetric

Low-energy defibrillation using a base-apex epicardial electrode.

Pacing Clin Electrophysiol

UT-Heart Inc., Setagaya-ku, Tokyo, Japan.

Published: November 2023

AI Article Synopsis

  • * Researchers tested different configurations and distances between sheet-shaped electrodes on a heart simulator to find the optimal setup for minimizing the defibrillation threshold (DFT).
  • * Results indicated that specific arrangements of electrodes, particularly with insulation, can lower the DFT and support painless defibrillation, paving the way for improved ICD designs.

Article Abstract

Background: Current implantable cardioverter defibrillators (ICDs) require electric conduction with high voltage and high energy, which can impair cardiac function and induce another malignant arrhythmia. As a result, there has been a demand for an ICD that can effectively operate with lower energy to mitigate the risks of a strong electric shock.

Methods: A pair of sheet-shaped electrodes covering the heart were analyzed in three configurations (top-bottom, left-right, and front-back) using a heart simulator. We also varied the distance between the two electrodes (clearance) to identify the electrode shape with the lowest defibrillation threshold (DFT). We also investigated the ICD shock waveform, shock direction, and the effect of the backside insulator of the electrode.

Results: The DFT was high when the clearance was too small and the DFT was high even when the clearance was too large, suggesting that an optimal value clearance. The top-bottom electrodes with optimal clearance showed the lowest DFT when the biphasic shocks set the top electrode to a high potential first and then the bottom electrode was set to a high potential. An interval between a first shock waveform and a second shock waveform should be provided for low-energy defibrillation. Because the insulator prevents unnecessary current flow to the backside, the DFT of the electrodes with insulators is less than those without insulators.

Conclusion: Painless defibrillation using sheet-shaped electrodes on the epicardium is predicated on the basis of results using a heart simulator.

Download full-text PDF

Source
http://dx.doi.org/10.1111/pace.14832DOI Listing

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