Atrial defibrillation with a transvenous lead
A randomized comparison of active can shocking pathways
Michael Cooklin, MD, MRCPa,
Mary R. Olsovsky, MDa,
Randall G. Brockman, MDa,
Stephen R. Shorofsky, MD, PhD, FACCa and
Michael R. Gold, MD, PhD, FACCa
a Department of Medicine, Division of Cardiology, University of Maryland Medical System, Baltimore, Maryland, USA
View larger version (20K):
[in a new window]
|
Figure 1 A schematic representation of the defibrillation shocking pathways. The dual-coil transvenous lead is positioned so that the tip is in the right ventricular apex. (A) The triad configuration is shown in which the distal coil in the right ventricle serves as the anode (+) for defibrillation. The pectoral can is connected electrically to the proximal atrial coil and serves as the cathode (–). (B) The transatrial configuration is shown in which the can alone serves as the cathode with the proximal coil as the anode.
|
|
View larger version (20K):
[in a new window]
|
Figure 2 Distribution of atrial defibrillation thresholds. Histograms of atrial defibrillation thresholds (ADFT) are shown for the triad (top panel), transatrial (middle panel) and optimal (bottom panel) configurations. The optimal configuration was the configuration with the lower of the two defibrillation thresholds in the patient.
|
|
View larger version (11K):
[in a new window]
|
Figure 3 The relationship between left atrial size and atrial defibrillation theshold. A scatter plot is presented. The line is the linear regression fit of the data.
|
|
|
