TY - JOUR
T1 - Effect of AICD patch electrodes on the diastolic pressure-volume curve in pigs
AU - Auteri, Joseph S.
AU - Jeevanandam, Valluvan
AU - Bielefeld, Mark R.
AU - Sanchez, Juan A.
AU - Spotnitz, Henry M.
N1 - Funding Information:
Supported in part by grant HL-41163 from the US Public Health Service. We thank Mr Santos Cabreriza and Mr Renald von Muchow for technical assistance, Robert Sdacca, EngSaD, for statistical consultations, and Laura Pawlicky for assistance in preparing the manuscript.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1991/11
Y1 - 1991/11
N2 - 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.
AB - 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.
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U2 - 10.1016/0003-4975(91)91280-9
DO - 10.1016/0003-4975(91)91280-9
M3 - Article
C2 - 1953123
AN - SCOPUS:0025987307
SN - 0003-4975
VL - 52
SP - 1052
EP - 1057
JO - The Annals of thoracic surgery
JF - The Annals of thoracic surgery
IS - 5
ER -