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document
Comparison of single- and dual-coil active pectoral defibrillation lead systems . OBJECTIVES The purpose of this study was to compare defibrillation thresholds with lead systems consisting of an active left pectoral electrode and either single or dual transvenous coils . BACKGROUND Lead systems that include an active pectoral pulse generator reduce defibrillation thresholds and permit transvenous defibrillation in nearly all patients . A further improvement in defibrillation efficacy is desirable to allow for smaller pulse generators with a reduced maximal output . METHODS This prospective study was performed in 50 consecutive patients . Each patient was evaluated with two lead configurations with the order of testing randomized . Shocks were delivered between the right ventricular coil and either an active can alone ( single coil ) or an active can with the proximal atrial coil ( dual coil ) . The right ventricular coil was the cathode for the first phase of the biphasic defibrillation waveform . RESULTS Delivered energy at the defibrillation threshold was 10.1+/-5.0 J for the single-coil configuration and 8.7+/-4.0 J for the dual-coil configuration ( p < 0.02 ) . Moreover , 98 % of patients had low ( < 15 J ) thresholds with the dual-coil lead system , compared with 88 % of patients with the single-coil configuration ( p=0.05 ) . Leading edge voltage ( p < 0.001 ) and shock impedance ( p < 0.001 ) were also decreased with the dual-coil configuration , although peak current was increased ( p < 0.001 ) . CONCLUSIONS A dual-coil , active pectoral lead system reduces defibrillation energy requirements compared with a single-coil , unipolar configuration .
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Intervention_Physical
single- and dual-coil active pectoral defibrillation lead systems .
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Intervention_Other
single
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Intervention_Other
dual transvenous coils
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Intervention_Physical
lead configurations
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Intervention_Physical
( single coil )
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Intervention_Physical
( dual coil )
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Intervention_Other
single-coil
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Intervention_Other
dual-coil
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Intervention_Other
dual-coil
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Intervention_Other
single-coil
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Intervention_Other
dual-coil
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Intervention_Other
dual-coil
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Intervention_Other
single-coil
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Outcome_Other
defibrillation efficacy
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Outcome_Other
Delivered energy
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Outcome_Physical
defibrillation threshold
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Outcome_Physical
thresholds
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Outcome_Other
Leading edge voltage
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Outcome_Other
shock impedance
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Outcome_Other
peak current
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Outcome_Other
defibrillation energy requirements
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Participant_Sample-size
50
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Participant_Sample-size
98 %
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Participant_Condition
88 %