Sequential pulse countershock between two transvenous catheters: feasibility, safety, and efficacy.

Pacing and Clinical Electrophysiology : PACE
R YeeM J Kallok

Abstract

We evaluated the feasibility, safety, and efficacy of sequential pulse countershock (SqCS) delivered solely through two endocardial catheters for the termination of ventricular tachycardia (VT) and fibrillation (VF) in patients undergoing electrophysiology studies (EPS). Thirty-four patients (31 men, 3 women) with a mean age of 56.8 +/- 10.1 years were studied. Etiology of VT/VF was ischemic heart disease (n = 26), cardiomyopathy (4) repaired tetralogy of Fallot (n = 1), heart transplant (n = 1), and no identifiable heart disease (n = 2). Catheters were positioned successfully in 29 patients. These were positioned in the right ventricular apex (RVA) and the coronary sinus (CS), respectively. The RVA electrode served as the common cathode for both pulses. The two electrodes located near the right atrium/superior vena cava junction served as anode for pulse 1 while the distal CS electrodes served as anode for pulse 2. Twenty-nine induced VT episodes with cycle length (CL) 220-370 msec were treated. SqCS successfully terminated 15 VT (100-500V) while 14 were accelerated or degenerated to VF. VTCL was longer in successful SqCS episodes than in those that were accelerated (285 +/- 17.3 vs 245 +/- 30.8 msec, P less than .003). Of 26 ...Continue Reading

References

Mar 1, 1988·Journal of the American College of Cardiology·D L JonesA D Sharma
Jan 1, 1972·Transactions - American Society for Artificial Internal Organs·M MirowskiR Denniston
Aug 7, 1980·The New England Journal of Medicine·M MirowskiM L Weisfeldt
Nov 1, 1982·The American Journal of Cardiology·R YeeG J Klein

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Citations

Nov 21, 2000·The American Journal of Cardiology·E MeiselD Pfeiffer
Nov 1, 1990·Pacing and Clinical Electrophysiology : PACE·W Irnich
Jan 1, 1993·Pacing and Clinical Electrophysiology : PACE·M W KrollT P Adams
Jun 1, 1997·Pacing and Clinical Electrophysiology : PACE·Z CsanadiG J Klein

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