Stability of the defibrillation probability curve with the development of ventricular dysfunction in the canine rapid paced model

Paul Andrew Friedman, David A. Foley, Timothy F. Christian, Marshall S. Stanton

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Most patients with implantable defibrillators have diminished cardiac function. Progressive heart failure might impair defibrillation efficacy, leading to interpreted device failure. This study sought to determine the effect of ventricular dysfunction on defibrillation energy using a biphasic endocardial system. Eleven dogs were ventricularly paced at 225 pulses/min for 2 weeks to induce ventricular dysfunction, and five control dogs remained unpaced. Dose response defibrillation probability curves were generated for each animal at baseline, after 2 weeks (at which time the pacemakers were turned off in the paced group), and then 1 week later. The defibrillation thresholds, ED20, ED50, and ED60 (the 20%, 50%, and 80% effective defibrillation energies, respectively) were determined for each dog at each study. In the paced dogs, the mean ejection fraction fell from 55% to 25% after pacing (P < 0.0001), and rose to 46% after its discontinuation (P = 0.0002). The defibrillation threshold, ED20, ED50, and ED80 remained unchanged in both the control and paced groups for all three studies, even after adjustment for dog weight or left ventricular mass. Rapid pacing produced no change in left ventricular mass. It induced ventricular cavity dilatation and wall thinning, which had opposing effects on defibrillation energy requirements, resulting in no net change of the ED50 in heart failure. In conclusion, the defibrillation efficacy of a biphasic transvenous system is not changed by the development of heart failure using the rapid paced canine model.

Original languageEnglish (US)
Pages (from-to)339-351
Number of pages13
JournalPACE - Pacing and Clinical Electrophysiology
Volume21
Issue number2
DOIs
StatePublished - 1998

Fingerprint

Ventricular Dysfunction
Canidae
Dogs
Heart Failure
Equipment Failure
Implantable Defibrillators
Dilatation
Weights and Measures
Control Groups

Keywords

  • Canine model
  • Cardiomyopathy
  • Defibrillation threshold
  • Electrical countershock
  • Heart failure
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Stability of the defibrillation probability curve with the development of ventricular dysfunction in the canine rapid paced model. / Friedman, Paul Andrew; Foley, David A.; Christian, Timothy F.; Stanton, Marshall S.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 21, No. 2, 1998, p. 339-351.

Research output: Contribution to journalArticle

@article{815e09888a304f1aa54cb2568262c82c,
title = "Stability of the defibrillation probability curve with the development of ventricular dysfunction in the canine rapid paced model",
abstract = "Most patients with implantable defibrillators have diminished cardiac function. Progressive heart failure might impair defibrillation efficacy, leading to interpreted device failure. This study sought to determine the effect of ventricular dysfunction on defibrillation energy using a biphasic endocardial system. Eleven dogs were ventricularly paced at 225 pulses/min for 2 weeks to induce ventricular dysfunction, and five control dogs remained unpaced. Dose response defibrillation probability curves were generated for each animal at baseline, after 2 weeks (at which time the pacemakers were turned off in the paced group), and then 1 week later. The defibrillation thresholds, ED20, ED50, and ED60 (the 20{\%}, 50{\%}, and 80{\%} effective defibrillation energies, respectively) were determined for each dog at each study. In the paced dogs, the mean ejection fraction fell from 55{\%} to 25{\%} after pacing (P < 0.0001), and rose to 46{\%} after its discontinuation (P = 0.0002). The defibrillation threshold, ED20, ED50, and ED80 remained unchanged in both the control and paced groups for all three studies, even after adjustment for dog weight or left ventricular mass. Rapid pacing produced no change in left ventricular mass. It induced ventricular cavity dilatation and wall thinning, which had opposing effects on defibrillation energy requirements, resulting in no net change of the ED50 in heart failure. In conclusion, the defibrillation efficacy of a biphasic transvenous system is not changed by the development of heart failure using the rapid paced canine model.",
keywords = "Canine model, Cardiomyopathy, Defibrillation threshold, Electrical countershock, Heart failure, Ventricular fibrillation",
author = "Friedman, {Paul Andrew} and Foley, {David A.} and Christian, {Timothy F.} and Stanton, {Marshall S.}",
year = "1998",
doi = "10.1111/j.1540-8159.1998.tb00058.x",
language = "English (US)",
volume = "21",
pages = "339--351",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Stability of the defibrillation probability curve with the development of ventricular dysfunction in the canine rapid paced model

AU - Friedman, Paul Andrew

AU - Foley, David A.

AU - Christian, Timothy F.

AU - Stanton, Marshall S.

PY - 1998

Y1 - 1998

N2 - Most patients with implantable defibrillators have diminished cardiac function. Progressive heart failure might impair defibrillation efficacy, leading to interpreted device failure. This study sought to determine the effect of ventricular dysfunction on defibrillation energy using a biphasic endocardial system. Eleven dogs were ventricularly paced at 225 pulses/min for 2 weeks to induce ventricular dysfunction, and five control dogs remained unpaced. Dose response defibrillation probability curves were generated for each animal at baseline, after 2 weeks (at which time the pacemakers were turned off in the paced group), and then 1 week later. The defibrillation thresholds, ED20, ED50, and ED60 (the 20%, 50%, and 80% effective defibrillation energies, respectively) were determined for each dog at each study. In the paced dogs, the mean ejection fraction fell from 55% to 25% after pacing (P < 0.0001), and rose to 46% after its discontinuation (P = 0.0002). The defibrillation threshold, ED20, ED50, and ED80 remained unchanged in both the control and paced groups for all three studies, even after adjustment for dog weight or left ventricular mass. Rapid pacing produced no change in left ventricular mass. It induced ventricular cavity dilatation and wall thinning, which had opposing effects on defibrillation energy requirements, resulting in no net change of the ED50 in heart failure. In conclusion, the defibrillation efficacy of a biphasic transvenous system is not changed by the development of heart failure using the rapid paced canine model.

AB - Most patients with implantable defibrillators have diminished cardiac function. Progressive heart failure might impair defibrillation efficacy, leading to interpreted device failure. This study sought to determine the effect of ventricular dysfunction on defibrillation energy using a biphasic endocardial system. Eleven dogs were ventricularly paced at 225 pulses/min for 2 weeks to induce ventricular dysfunction, and five control dogs remained unpaced. Dose response defibrillation probability curves were generated for each animal at baseline, after 2 weeks (at which time the pacemakers were turned off in the paced group), and then 1 week later. The defibrillation thresholds, ED20, ED50, and ED60 (the 20%, 50%, and 80% effective defibrillation energies, respectively) were determined for each dog at each study. In the paced dogs, the mean ejection fraction fell from 55% to 25% after pacing (P < 0.0001), and rose to 46% after its discontinuation (P = 0.0002). The defibrillation threshold, ED20, ED50, and ED80 remained unchanged in both the control and paced groups for all three studies, even after adjustment for dog weight or left ventricular mass. Rapid pacing produced no change in left ventricular mass. It induced ventricular cavity dilatation and wall thinning, which had opposing effects on defibrillation energy requirements, resulting in no net change of the ED50 in heart failure. In conclusion, the defibrillation efficacy of a biphasic transvenous system is not changed by the development of heart failure using the rapid paced canine model.

KW - Canine model

KW - Cardiomyopathy

KW - Defibrillation threshold

KW - Electrical countershock

KW - Heart failure

KW - Ventricular fibrillation

UR - http://www.scopus.com/inward/record.url?scp=0031911094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031911094&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8159.1998.tb00058.x

DO - 10.1111/j.1540-8159.1998.tb00058.x

M3 - Article

VL - 21

SP - 339

EP - 351

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 2

ER -