Ventricular pacing thresholds following high-energy implantable cardioverter defibrillator shocks in integrated bipolar defibrillation systems |
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Authors: | Yoshio Yamanouchi Kei Miyoshi Sunao Kodama Yuhei Shiga Shunichiro Sumi Hideya Niimura Hideaki Toujou and Hidenori Urata |
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Institution: | Department of Cardiology, Chikushi Hospital, Fukuoka University, Fukuoka, Japan |
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Abstract: | BACKGROUND:Increased ventricular pacing thresholds have been observed following monophasic implantable cardioverter defibrillator (ICD) shocks.AIM:To examine changes following high-energy biphasic shocks delivered by integrated bipolar ICD systems.METHOD:Ten episodes of ventricular fibrillation (VF) were induced at 10 min intervals in nine pigs with integrated ICD systems. After 10 s of each episode of VF, a 40 J biphasic shock was delivered, which successfully terminated VF (a total of 10 shocks). The bipolar pacing threshold at the right ventricular apex was measured before each shock and at 1 min intervals after each shock.RESULTS:The mean pacing threshold was 0.029±0.059 μJ before the first shock and gradually increased to 0.14±0.10 μJ after the 10th shock.CONCLUSION:It may be necessary to pace at a high-voltage output following biphasic shocks delivered by integrated bipolar ICD systems. |
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Keywords: | High-energy ICD shock Pacing threshold |
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