Luceri R M, Accorti P R
Florida Arrhythmia Consultants, Fort Lauderdale 33308, USA.
Pacing Clin Electrophysiol. 1997 Jan;20(1 Pt 2):168-72. doi: 10.1111/j.1540-8159.1997.tb04836.x.
The use of transvenous ICD systems and the recent advances in atrial defibrillation techniques have heightened interest in internal defibrillation. However, most shocks for induced or spontaneous arrhythmias in patients without devices are still delivered transthoracically using high energy. We describe the history of temporary internal defibrillation techniques and report the initial clinical results with a custom built disposable catheter for internal cardioversion and defibrillation. This prototype successfully converted more than 95% of 109 episodes of VT or VF in 28 patients, with biphasic energies < or = 20 J. A newer disposable catheter, using 40-wire Matrix technology as the defibrillating electrode, has design features that provide high surface area, low impedance, and low current density when compared to other leads used for similar purposes. Temporary internal cardioversion-defibrillation of induced and spontaneous arrhythmias using such catheter designs is likely to be widely applicable to patients undergoing electrophysiology procedures and to those in critical care units prone to tachyarrhythmias.
经静脉植入式心脏除颤器系统的应用以及心房除颤技术的最新进展，提高了人们对体内除颤的兴趣。然而，对于未植入设备的患者，大多数针对诱发性或自发性心律失常的电击仍通过经胸高能量方式进行。我们描述了临时体内除颤技术的历史，并报告了使用定制的一次性导管进行体内心脏复律和除颤的初步临床结果。该原型成功地将28例患者的109次室性心动过速（VT）或室颤（VF）发作中的95%以上进行了复律，双相能量≤20焦耳。一种采用40线矩阵技术作为除颤电极的新型一次性导管，与用于类似目的的其他导联相比，具有高表面积、低阻抗和低电流密度的设计特点。使用这种导管设计对诱发性和自发性心律失常进行临时体内心脏复律-除颤，可能广泛适用于接受电生理检查的患者以及重症监护病房中易发生快速性心律失常的患者。
