title: Comparison of the efficacy of a subcutaneous array electrode with a subcutaneous patch electrode, a prospective randomized study.
abstract: The patch electrode and the array electrode are the two types of subcutaneous leads available as an adjunct to a transvenous lead system in patients with high defibrillation thresholds. A prospective randomized study was conducted in 30 consecutive patients comparing the efficacy and the long-term performance of a patch electrode with an array electrode. After determination of the defibrillation threshold for the transvenous lead alone, a subcutaneous patch or an array electrode was implanted in random order. Adding a patch electrode decreased the defibrillation threshold in seven out of 15 patients (47%) from 13.2+/-6.6 to 10.5+/-5.1 J (P<0.05). In 13 out of 15 patients (87%), the implantation of an array electrode caused a significant lowering of the defibrillation threshold from 15.4+/-6.6 to 8.2+/-5.0 J (P<0.0001). The array electrode was significantly more effective in lowering the defibrillation threshold than the patch electrode (P<0.01). Complications during follow-up associated with the subcutaneous patch electrode were observed in four patients whereas no complications were associated with the array electrode (P<0.01). The additional implantation of an array electrode is more effective and associated with fewer complications compared to a patch electrode.
authors.affiliation: Medical Department III, University Hospital Tübingen, Otfried Müller Str. 10, D-72076, Tübingen, Germany. volker.kuehlkamp@med.uni-tuebingen.de
authors.forename: V
authors.initials: V
authors.lastname: Kühlkamp
authors.forename: V
authors.initials: V
authors.lastname: Dörnberger
authors.forename: C
authors.initials: C
authors.lastname: Mewis
authors.forename: L
authors.initials: L
authors.lastname: Seipel
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation*; D017097:Electric Impedance; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy*