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PubMed · 10412072

Automated external defibrillator selection considerations.

Abstract

Before buying an automated external defibrillator (AED), you need answers to some fundamental questions about the technology. The AED Evaluations we've published provide most of the answers you need, but there are some questions that require additional comment. For example: Are low-energy biphasic AEDs as safe and effective as units that use the more traditional monophasic technology? Will rechargeable or nonrechargeable batteries prove the best choice for your organization? And should differences in units' ECG-rhythm-recognition algorithms affect your purchasing decision? We address these questions, describing the issues to consider and recommending courses of action, in the articles that follow.

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Automated external defibrillator selection considerations.. https://pubmed.ncbi.nlm.nih.gov/10412072/

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A biventricular ICD system with biventricular defibrillation.

We describe the case of a 59-year-old gentleman with severe dilated cardiomyopathy requiring implantation of a dual-chamber biventricular implantable cardioverter-defibrillator (ICD). High defibrillation thresholds (DFT) were encountered at implant with an inadequate defibrillation safety margin. Testing of all possible shock vectors/polarities with and without the SVC coil and optimization of the distal RV coil position all proved inadequate. A satisfactory defibrillation safety margin was achieved following placement of a second lead in the coronary sinus to enable biventricular defibrillation. This case highlights an additional strategy for combating high DFTs and is an option even in dual-chamber biventricular ICD systems.

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