A patch in the pectoral position lowers defibrillation threshold

Pacing Clin Electrophysiol. 1997 Jun;20(6):1662-6. doi: 10.1111/j.1540-8159.1997.tb03536.x.

Abstract

Implantable pacemaker cardioverter defibrillators are now available with biphasic waveforms, which have been shown to markedly improve defibrillation thresholds (DFTs). However, in a number of patients the DFT remains high. Also, DFT may increase after implantation, especially if antiarrhythmic drugs are added. We report on the use of a subcutaneous patch in the pectoral position in 15 patients receiving a transvenous defibrillator as a method of easily reducing the DFT. A 660-mm2 patch electrode was placed beneath the generator in a pocket created on the pectoral fascia. The energy required for defibrillation was lowered by 56% on average, and the system impedance was lowered by a mean of 25%. This maneuver allowed all patients to undergo a successful implant with adequate safety margin.

MeSH terms

  • Defibrillators, Implantable*
  • Electric Impedance
  • Electrodes, Implanted*
  • Humans
  • Male
  • Middle Aged
  • Pectoralis Muscles