Effect of epicardial patch electrodes on transthoracic defibrillation.
Effect of epicardial patch electrodes on transthoracic defibrillation.
复制标题
心外膜贴片电极对经胸除颤的影响。
DOI：
10.1161/01.cir.81.4.1409
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发表时间：
1990
期刊：
影响因子：
37.8
通讯作者：
Deale,OC
中科院分区：
文献类型：
--
作者：
Lerman,BB;Deale,OC
为了提高接受恶性室性心动过速（VT）外科消融手术的患者的生存率，通常的做法是在标测图引导手术时植入心外膜贴片电极。术后，诱导性室性心动过速患者通常接受自动内部心律转复/除颤器（AICD）植入，而非诱导性室性心动过速患者通常不接受。然而，如果非诱发性VT患者随后发生自发性、膨胀性VT或心室颤动，则经胸除颤和复苏可能很困难，因为贴片电极采用硅橡胶绝缘，硅橡胶可以减少穿过心肌的电流量，从而可以增加经胸除颤阈值（DFT）。在这项研究中，在杂种犬中测定DFT，以检验心外膜贴片电极升高阈值的假设。本研究还旨在评估贴片电极方向和尺寸对DFT的影响。在第一个方案（垂直方向）中，将小的心外膜贴片电极（表面积，30 cm 2）缝合到15只犬的右前心室和左后心室的心外膜表面，使贴片电极的中心轴重合并垂直于经胸电极的重合中心轴。还在其中8只犬中检查了两个大型心外膜贴片电极（表面积，53 cm 2）对经胸DFT的影响。在第二个方案（平行方向）中，将小贴片电极缝合到7只犬的右心室和左心室的侧面。（250字处删节）
To improve survival rates in patients undergoing surgical ablative procedures for malignant ventricular tachycardia (VT), a frequent practice is to implant epicardial patch electrodes at the time of map-guided surgery. After operation, patients with inducible VT often receive an automatic internal cardioverter/defibrillator (AICD) implant, whereas patients with noninducible VT usually do not. In the event that spontaneous, hypotensive VT or ventricular fibrillation should subsequently occur in the patient with noninducible VT, however, transthoracic defibrillation and resuscitation may prove difficult, because the patch electrodes are insulated with silicone rubber that can reduce the amount of current traversing the myocardium and thus can increase transthoracic defibrillation threshold (DFT). In this study, DFT was determined in mongrel dogs to test the hypothesis that epicardial patch electrodes elevate threshold. This study was also designed to assess the effect of patch electrode orientation and size on DFT. In the first protocol (perpendicular orientation), small epicardial patch electrodes (surface area, 30 cm2) were sutured to the epicardial surfaces of the anterior right and posterior left ventricles in 15 dogs so that the center axes of the patch electrodes were coincident and perpendicular to the coincident center axes of the transthoracic electrodes. The effect of two large epicardial patch electrodes (surface area, 53 cm2) on transthoracic DFT was also examined in eight of these dogs. In the second protocol (parallel orientation), small patch electrodes were sutured to the lateral surfaces of the right and left ventricles in seven dogs.(ABSTRACT TRUNCATED AT 250 WORDS)