title: External cardiac defibrillation does not cause acute histopathological changes typical of thermal injuries in pigs with in situ cerebral stimulation electrodes.
abstract: Parkinson's disease patients with long-term L-dopa syndrome may benefit from an implanted cerebral stimulation device. When advanced life support demands cardioversion or defibrillation in these patients, undesired effects of monophasic electroshocks might occur in brain tissue adjacent to the stimulation electrodes (e.g., thermal injury), but also in the stimulation device itself. Thus, in this animal study (n = 6 pigs), we investigated the effects of repeated defibrillation (2 x 200 J [n = 1] and 2 x 360 J [n = 5]) at the implantation site of cerebral stimulation electrodes and on stimulation device function. Repeated external cardiac defibrillation did not cause acute histopathologic changes typical of thermal injury to brain tissue adjacent to the cerebral stimulation electrodes. Functionality of the stimulator device after defibrillation, however, ranged from normal to total loss of function. Therefore, when defibrillation is performed, the greatest possible distance between the defibrillation site and the stimulator device implantation site should be considered. Subsequent testing of the stimulator device's function is mandatory.
  
  
  CONCLUSIONS
  Repeated cardiac defibrillation did not cause histopathologic changes typical of thermal injury at the implantation site of cerebral stimulation electrodes. The function of the stimulator device after defibrillation, however, ranged from normal to total loss of function.
authors.affiliation: Departments of *Anaesthesia and Intensive Care Medicine, †Neurosurgery, ‡Vascular Surgery, and §Pathology, University of Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Kolbitsch
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Eisner
authors.forename: Axel
authors.initials: A
authors.lastname: Kleinsasser
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Thomas
authors.initials: T
authors.lastname: Fiegele
authors.forename: Alexander
authors.initials: A
authors.lastname: Löckinger
authors.forename: Ingo H
authors.initials: IH
authors.lastname: Lorenz
authors.forename: Gregor
authors.initials: G
authors.lastname: Mikuz
authors.forename: Patrizia L
authors.initials: PL
authors.lastname: Moser
mesh_terms: D000241:Adenosine / Q000494:pharmacology; D000818:Animals; D001921:Brain / Q000473:pathology*; D002056:Burns / Q000473:pathology*; D004554:Electric Countershock; D004558:Electric Stimulation; D004562:Electrocardiography; D004567:Electrodes, Implanted / Q000009:adverse effects*; D013552:Swine; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine