title: Effects of physical parameters of fulguration on electrophysiological and anatomical properties of canine myocardium.
abstract: In order to determine the respective roles of catheter (Ct) physical properties and of energy levels in myocardial effects of fulguration, we delivered an electrical shock between the tip electrode of a Ct placed at the apex of the right ventricle and a large cutaneous cathodal electrode in 12 dogs. Two energy levels were used: Group A = 25 J (n = 6) and group B = 100 J (n = 6), and three Cts were studied. These Cts had different resistances (R) and active surface electrodes (S): Ct 1 (R = 0.3 omega, S = 12 mm2), Ct 2 (R = 0.3 omega, S = 2 mm2), Ct 3 (R = 2 omega, S = 13 mm2). Complex ventricular arrhythmias were observed in 5/6 cases at 100 J but only in 1/6 cases at 25 J and were independent of the Ct type. Following the shock, the effective ventricular refractory period (S1 S1 = 300 msec) increased significantly only at 100 J (11%, p = 0.03). Anatomical lesions were wider (10.6 vs. 5.2 mm, p less than 0.05) and deeper (100 vs. 55%, p less than 0.05) in the 100 J group. In contrast, there was no significant difference in the electrophysiological and anatomical changes between the three Cts. In conclusion, arrhythmogenic adverse effects of ventricular Ct fulguration are related to the delivered energy; on the contrary, they seem only slightly dependent on Ct physical properties at these energy levels; a 2 J/kg shock is not only effective but also seems to be safe.
mesh_terms: D000818:Animals; D004285:Dogs; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography; D004566:Electrodes; D004594:Electrophysiology; D009206:Myocardium / Q000473:pathology; D013610:Tachycardia / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*