A Novel Defibrillation Tool: Percutaneously Delivered, Partially Insulated Epicardial Defibrillation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F17%3A00067087" target="_blank" >RIV/00159816:_____/17:00067087 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/17:00096705

Výsledek na webu

<a href="http://dx.doi.org/10.1016/j.jacep.2016.12.025" target="_blank" >http://dx.doi.org/10.1016/j.jacep.2016.12.025</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jacep.2016.12.025" target="_blank" >10.1016/j.jacep.2016.12.025</a>

Jazyk výsledku

angličtina

Název v původním jazyce

A Novel Defibrillation Tool: Percutaneously Delivered, Partially Insulated Epicardial Defibrillation

Popis výsledku v původním jazyce

Epicardial defibrillation systems currently require surgical access. We aimed to develop a percutaneous defibrillation system with partially-insulated epicardial coils to focus electrical energy on the myocardium and prevent or minimize extra-cardiac stimulation. METHODS: We tested 2 prototypes created for percutaneous introduction into the pericardial space via a steerable sheath. This included a partially-insulated defibrillation coil and a defibrillation mesh with a urethane balloon acting as an insulator to the face of the mesh not in contact with the epicardium. The average energy associated with a chance of successful defibrillation 75% of the time (ED75) was calculated for each experiment. RESULTS: Of 16 animal experiments, 3 pig experiments had malfunctioning mesh prototypes such that results were unreliable; these were excluded. Therefore, 13 animal experiments were analyzed - 6 canines (29.8+-4.0kg); 7 pigs (41.1+-4.4kg). The overall ED75 was 12.8+-6.7J (10.9+-9.1J for canines; 14.4+-3.9J in pigs [P=0.37]). The lowest ED75 obtained in canines was 2.5J while in pigs it was 9.5J. The lowest energy resulting in successful defibrillation was 2J in canines and 5J in pigs. There was no evidence of coronary vessel injury or trauma to extra-pericardial structures. CONCLUSION: Percutaneous, epicardial defibrillation using a partially insulated coil is feasible and appears to be associated with low defibrillation thresholds. Focusing insulation may limit extra-cardiac stimulation and potentially lower energy requirements for efficient defibrillation.

Název v anglickém jazyce

A Novel Defibrillation Tool: Percutaneously Delivered, Partially Insulated Epicardial Defibrillation

Popis výsledku anglicky

Epicardial defibrillation systems currently require surgical access. We aimed to develop a percutaneous defibrillation system with partially-insulated epicardial coils to focus electrical energy on the myocardium and prevent or minimize extra-cardiac stimulation. METHODS: We tested 2 prototypes created for percutaneous introduction into the pericardial space via a steerable sheath. This included a partially-insulated defibrillation coil and a defibrillation mesh with a urethane balloon acting as an insulator to the face of the mesh not in contact with the epicardium. The average energy associated with a chance of successful defibrillation 75% of the time (ED75) was calculated for each experiment. RESULTS: Of 16 animal experiments, 3 pig experiments had malfunctioning mesh prototypes such that results were unreliable; these were excluded. Therefore, 13 animal experiments were analyzed - 6 canines (29.8+-4.0kg); 7 pigs (41.1+-4.4kg). The overall ED75 was 12.8+-6.7J (10.9+-9.1J for canines; 14.4+-3.9J in pigs [P=0.37]). The lowest ED75 obtained in canines was 2.5J while in pigs it was 9.5J. The lowest energy resulting in successful defibrillation was 2J in canines and 5J in pigs. There was no evidence of coronary vessel injury or trauma to extra-pericardial structures. CONCLUSION: Percutaneous, epicardial defibrillation using a partially insulated coil is feasible and appears to be associated with low defibrillation thresholds. Focusing insulation may limit extra-cardiac stimulation and potentially lower energy requirements for efficient defibrillation.

Druh

J_SC - Článek v periodiku v databázi SCOPUS

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

JACC: Clinical Electrophysiology

ISSN

2405-500X

e-ISSN

—

Svazek periodika

3

Číslo periodika v rámci svazku

7

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

474-755

Kód UT WoS článku

—

EID výsledku v databázi Scopus

2-s2.0-85016514647