This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lerman, B. B. Articles by Weisfeldt, M. L. Search for Related Content PubMed PubMed Citation Articles by Lerman, B. B. Articles by Weisfeldt, M. L.

Circulation, Vol 69, 1006-1012, Copyright © 1984 by American Heart Association

ARTICLES

Myocardial injury and induction of arrhythmia by direct current shock delivered via endocardial catheters in dogs

BB Lerman, JL Weiss, BH Bulkley, LC Becker and ML Weisfeldt

Although electrical ablation of ventricular tachycardia via percutaneous catheters has been recently accomplished in human beings, little is known of its pathologic or arrhythmogenic effects. We studied 21 open-chest anesthetized dogs in which an endocardial electrode catheter was percutaneously introduced into the left ventricle. Direct current (DC) shock was delivered by a standard defibrillator through the distal electrode to a back paddle. Cross-sectional two-dimensional echocardiographic studies were performed in the plane of the catheter (confirmed by epicardial metal beads), and blood flow was determined by the microsphere technique before DC shock and when the animals were killed 2 to 8 days later. Of 11 dogs receiving a total of 100 to 400 J, only three survived 48 hr compared with nine of 10 receiving 50 J and all three control dogs. Holter monitoring demonstrated sustained ventricular tachycardia (VT) (greater than or equal to 30 sec) in all 11 dogs monitored (six received greater than or equal to 100 J), beginning within 5 hr of the DC shock; three control dogs had no VT. Two dogs that died suddenly while being monitored showed ventricular fibrillation. Histologic examination revealed hemorrhagic contraction band necrosis in the shock zone, a type of injury similar to that observed in reperfusion necrosis. Necrosis of the left ventricle was 0.5% to 5%. There was no significant difference in necrosis between dogs receiving 100 J or more and those receiving 50 J (2.5 vs 1.7 g; p greater than .10). Percent systolic thickening determined in eight equally divided regions around the left ventricle showed no difference between the shock zone, perishock zone, or remote normal zone in dogs receiving 50 J.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				A. Goette, W. Hartung, M. Lesh, C. Honeycutt, S. Fleischman, D. Swanson, and J. Langberg Transcatheter Subendocardial Infusion: A Novel Technique for Mapping and Ablation of Ventricular Myocardium Circulation, September 15, 1996; 94(6): 1449 - 1455. [Abstract] [Full Text]

				L. L. Mickleborough, S. Mizuno, A. Usui, G. Wilson, D. McComb, and G. Gray Balloon electric shock ablation--A surgical technique for treatment of ventricular tachycardia: Influence of endocardial scar on depth of ablation achieved J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 855 - 861. [Abstract] [Full Text]