Successful atrial defibrillation with very-low-energy shocks by means of temporary epicardial wire electrodes

The Journal of Thoracic and Cardiovascular Surgery
B L CmolikA L Waldo

Abstract

Sustained atrial fibrillation is very common after cardiac surgical procedures. We hypothesized that atrial defibrillation could be accomplished consistently and safely by means of low-energy shocks delivered by temporary stainless steel wire electrodes placed at the time of the operation. Sterile pericarditis was created in five mongrel dogs (20.9 +/- 2.1 kg), and pairs of standard temporary stainless steel wire electrodes were placed on the right atrial appendage, on Bachmann's bundle, and on the right ventricular apex for pacing, sensing, and recording. Temporary stainless steel wire electrodes, insulated except for the distal 6 cm and used to deliver defibrillation shocks, were placed adjacent to both atrial free walls and secured to the pericardium. All electrodes were brought out through the skin, and the sternotomy was closed. Dogs were tested in the conscious state on postoperative day 2. Sustained atrial fibrillation was induced by rapid atrial pacing. A customized software program was used to control the defibrillator, which delivered R wave-synchronous biphasic shocks to the atria through the temporary defibrillation electrodes. The shock intensity began at 50 volts and was increased by 10-volt increments until atria...Continue Reading

References

Sep 1, 1992·Journal of the American College of Cardiology·A C PowellJ N Ruskin
Mar 1, 1990·International Journal of Cardiology·H YousifC M Oakley
Oct 1, 1986·Journal of the American College of Cardiology·P L PagéA L Waldo
Apr 1, 1968·Circulation·P D HarrisD H Singer
May 1, 1994·Pacing and Clinical Electrophysiology : PACE·E AltR Blasini
May 1, 1993·Circulation·R A CooperR E Ideker

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