التفاصيل البيبلوغرافية
| العنوان: |
Comparison of the Damped Sine Wave to the Capacitor Discharge for Low-Energy Electrical Catheter Ablation of the AV Junction in Dogs. |
| المؤلفون: |
Ayers, G. M., Wessale, J. L., Tacker Jr., W. A., Geddes, L. A., Bourland, J. D. |
| المصدر: |
Journal of Cardiovascular Electrophysiology; Aug1991, Vol. 2 Issue 4, p279-287, 9p, 1 Diagram, 3 Charts, 4 Graphs |
| مصطلحات موضوعية: |
DEFIBRILLATORS, ELECTRONICS in cardiology, CARDIAC catheterization, MYOCARDIUM, ARRHYTHMIA treatment, FLUOROSCOPY |
| مستخلص: |
Damped sine wave defibrillator discharges applied through an intracardiac catheter are used to ablate myocardium to achieve arrhythmia control. The objective of this study was to compare the relative effectiveness of damped sine wave shocks and capacitor discharge shocks of equal, low energies for producing complete atrioventricular (AV) block. In 12 anesthetized dogs (mean 26.2 kg, range 22-33 kg), an ablation catheter was positioned using fluoroscopy, intracardiac electrographic recording, and pacing criteria, and was anchored in place by suction. The shocks were delivered between the catheter-tip electrode and an 8-cm diameter plate (anode) on the left chest wall. Two low-energy shocks of about 1.3 joules were delivered, one of the pair being a damped sine wave, and the other being a capacitor discharge. Progressively higher, equal-energy, paired shocks were applied, with adequate time allowed between each shock for return of sinus rhythm. The period of AV block was measured from shock delivery to the return of AV conduction. Delivered energy was calculated from the voltage and current waveforms. When a shock produced complete AV block lasting 3 hours, no additional shocks were delivered, and the dog was recovered from anesthesia and monitored for 6 days. In 34 of 36 paired shocks, the capacitor discharge produced a longer duration of AV block than the damped sine wave. Analysis of covariance indicated a significant difference (P < 0.001) in the duration of AV block produced by the waveforms. Furthermore, five dogs remained in complete AV block for 6 days; in four of these dogs, the final shock was a capacitor discharge (energies of 1.1, 3.5,3.6, and 7.3 joules), and in one dog the final shock was a damped sine wave (3.9 joules). We conclude that the capacitor discharge is more effective than the damped sine wave for producing transient AV block. These results support the hypothesis that the capacitor discharge is more effective than the damped Sine wave for producing permanent complete AV block at low energies. [ABSTRACT FROM AUTHOR] |
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