Rubin L, Hudson P
Am J Emerg Med. 1985 Mar;3(2):160-4. doi: 10.1016/0735-6757(85)90042-7.
This study evaluated the energy requirements for porous electrodes implanted on the parietal pericardium versus those for porous electrodes implanted on the epicardial surface of the heart. Defibrillation with a 2.5-cm porous electrode implanted on the parietal pericardium was successful in 42% of all episodes of ventricular fibrillation. The minimal energy requirement ranged from 30-68 J, with an average of 46 J. Epicardial defibrillation was successful in approximately 80% of all episodes. The average maximal energy was 21.3 J. There was histological evidence of subepicardial damage in the parietal defibrillation group. This may be related to the higher energy required to defibrillate in this group. However, in this group frequent, large, external shocks were required to defibrillate the dogs' hearts. Theoretically, there may be some physiological and surgical advantages to an intact pericardium. However, the high energy requirement and the low success rate for defibrillation with a porous electrode on the parietal pericardium negate the feasibility of this route of defibrillation with a permanent implantable system.
本研究评估了植入于心包壁层的多孔电极与植入于心脏心外膜表面的多孔电极的能量需求。使用植入于心包壁层的2.5厘米多孔电极进行除颤，在所有室颤发作中有42%成功。最小能量需求范围为30 - 68焦耳，平均为46焦耳。心外膜除颤在所有发作中约80%成功。平均最大能量为21.3焦耳。心包壁层除颤组有组织学证据表明心外膜下有损伤。这可能与该组除颤所需能量较高有关。然而，在该组中，需要频繁、大量的外部电击来使犬类心脏除颤。从理论上讲，完整的心包可能具有一些生理和手术优势。然而，心包壁层多孔电极除颤的高能量需求和低成功率否定了使用永久植入系统进行这种除颤途径的可行性。
