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PubMed · 12356411

Determining the optimal paddle force for external defibrillation.

Charles D Deakin·Daniel M Sado·Graham W Petley·Frank Clewlow
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Electric CountershockHumansMyocardial InfarctionPractice Guidelines as TopicPressureRespiration, ArtificialJournal ArticleResearch Support, Non-U.S. Gov't

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Charles D Deakin, Daniel M Sado, Graham W Petley, Frank Clewlow. 2002-10-01. Determining the optimal paddle force for external defibrillation.. https://doi.org/10.1016/s0002-9149(02)02623-1

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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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