Electrophysiologic and anatomic changes in the atrioventricular junction of dogs after direct-current shocks through tissue fixation catheters.

Barb-tipped fixation electrode catheters were inserted under fluoroscopic control in the region of the atrioventricular (AV) node in 6 dogs. A series of direct-current shocks (20 to 240 J) were delivered from the electrode catheter to a back plate. Serial electrophysiologic studies were performed before and 2 to 3 weeks after delivery of the shocks. In general, low-energy shocks--20 to 180 J--resulted in predominant damage to the approaches to the AV node, the AV node and common bundle, whereas larger shocks created diffuse damage involving the His bundle and bundle branches. Despite histologic damage to the AV junction, only minimal changes in AV conduction were observed. Thus, there is a large safety margin for AV conduction.