Effect of AICD patch electrodes on the diastolic pressure-volume curve in pigs

Joseph S. Auteri, Valluvan Jeevanandam, Mark R. Bielefeld, Juan A. Sanchez, Henry M. Spotnitz

Research output: Contribution to journalArticle

Abstract

Although the automatic implantable cardioverter defibrillator (AICD) is effective against malignant ventricular arrhythmias, the effects of AICD patches on left ventricular diastolic properties have not been defined. Accordingly, extrapericardial (group E, n = 5) or intrapericardial (group I, n = 6) AICD patches were implanted through a median sternotomy in 11 anesthetized pigs. Six weeks later, using a left thoracotomy, the hearts were arrested with hypothermic cardioplegia. A balloon catheter was inserted into the left ventricle through the aortic root, and pressure-volume curves were measured before and after sequential removal of patches and pericardium. A dense intrapericardial fibrotic reaction in group I was not present in group E. Normalized left ventricular filling volumes in group E were significantly larger at pressures of 5.1 to 10, 15.1 to 20, and 20.1 to 28 mm Hg compared with group I (p < 0.05). We conclude that intrapericardial AICD patches adversely affect left ventricular diastolic pressure-volume relations and recommend that AICD patches be placed in the extrapericardial location clinically whenever possible.

Original languageEnglish (US)
Pages (from-to)1052-1057
Number of pages6
JournalThe Annals of thoracic surgery
Volume52
Issue number5
DOIs
StatePublished - Nov 1991

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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