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Circulation, Vol 58, 1190-1195, Copyright © 1978 by American Heart Association

ARTICLES

A conductive catheter to improve patient safety during cardiac catheterization

MJ Lipton, AK Ream and BH Hyndman

A 60 Hz current, as small as 20 microamperemeter (rms) is capable of causing ventricular fibrillation when directly applied to the heart. Significant cost and engineering effort has been spent to construct monitoring equipment which satisfies the safety regulations requiring maximum leakage currents below this value. Patients undergoing cardiac catheterization are particularly at risk from electrical hazards, primarily because catheters are made from nonconductive materials. A conductive catheter should allow externally applied currents to leak through its walls before reaching the catheter tip. A new electrically conductive catheter was compared with a standard nonconductive catheter. Five dogs were studied, with 81 attempts to cause fibrillation. Sixty-hertz voltage between the catheter and an external electrode was increased until fibrillation occurred or 130 V was reached. Eight states were studied in randomized sequence: conductive or nonconductive catheter, guidewire or saline-filled and tip touching wall, or free in left ventricle (verified by fluoroscopy and cineangiography). The saline-filled and conductive catheter was safer in that fibrillation never occurred, while fibrillation nearly always occurred with the nonconductive catheter. A conductive guidewire negates the protection of the conductive catheter. The application of conductive catheters could reduce instrumentation costs in laboratories and intensive care units and improve patient safety.