Department of Biomedical Engineering, The University of Memphis, Memphis, TN 38152, USA.
Ann Transl Med. 2015 Aug;3(14):196. doi: 10.3978/j.issn.2305-5839.2015.08.17.
Atrial fibrillation (AF) is a debilitating cardiac arrhythmia, one potential treatment of which is external cardioversion. Studies have shown external cardioversion success is affected by electrode placement and that esophageal electric fields (EEFs) during low strength shocks have the potential to be used in determining patient-specific optimal electrode placements during animal experiments. The objective of this study was to determine the relationship between EEFs and atrial defibrillation thresholds (ADFTs) during computer simulations using an anatomically realistic computer model of a human torso.
Over 600 electrode placements were simulated during which EEFs were compared to ADFTs.
There was no single optimal electrode placement with multiple electrode placements resulting in similarly low ADFTs. There was over 40% difference in the ADFTs between the most and least optimal electrode configurations. There was no correlation between EEFs and ADFTs for all electrode placements, but a strong negative correlation when small shifts from clinically relevant electrode placements were performed.
These results suggest a small shifts protocol from clinically relevant electrode placements has the potential to increase the probability of successful cardioversion on the first shock and reduce the cumulative number of shocks and energy to which patients are exposed.
心房颤动（AF）是一种使人衰弱的心律失常，其潜在的治疗方法之一是外部心脏复律。研究表明，外部心脏复律的成功率受电极放置的影响，在动物实验中，低强度电击时的食管电场（EEF）有可能用于确定特定患者的最佳电极放置。本研究的目的是使用人体胸部分型的计算机模型，在计算机模拟中确定 EEF 与心房除颤阈值（ADFT）之间的关系。
在超过 600 次的电极放置模拟中，比较了 EEF 和 ADFT。
没有单一的最佳电极放置位置，多个电极放置位置导致相似的低 ADFT。在最理想和最不理想的电极配置之间，ADFT 差异超过 40%。对于所有电极放置位置，EEF 与 ADFT 之间没有相关性，但在进行临床相关电极位置的小偏移时，相关性很强。
这些结果表明，从临床相关电极位置进行小的偏移协议，有可能增加首次电击成功的概率，并减少患者暴露的电击次数和能量。
