title: Impedance-gradient electrode reduces skin irritation induced by transthoracic defibrillation.
abstract: A new type of disposable external defibrillation electrode has been developed to reduce the skin irritation commonly associated with defibrillation and synchronised cardioversion. This design employs an impedance gradient to reduce the proportion of current delivered to the electrode periphery. The temperature distribution under the new electrode was compared with that of four other types of commercially available electrodes after repeated high-energy biphasic defibrillation discharges to domestic swine. Skin temperature distributions were acquired using non-invasive thermography. Measurements of the maximum temperature rise at each electrode site, taken 3.6s after the fifth defibrillation discharge, demonstrated that the new impedance-gradient electrode produced 50-60% less skin heating than two of the three uniform-impedance electrode designs. Histological examination of erythematous sites excised 24 h after defibrillation quantified the associated skin damage using a scoring protocol developed for this study. In contrast to previous studies, histological examinations demonstrated second-degree skin burns following defibrillation. The new electrode design, however, induced 44-46% less skin damage than two of the traditional uniform-impedance electrodes.
authors.affiliation: Tyco Healthcare Ludlow, Chicopee, MA, USA. peter.meyer@tycohealthcare.com
authors.forename: P F
authors.initials: PF
authors.lastname: Meyer
authors.forename: P D
authors.initials: PD
authors.lastname: Gadsby
authors.forename: D
authors.initials: D
authors.lastname: Van Sickle
authors.forename: W E
authors.initials: WE
authors.lastname: Schoenlein
authors.forename: K S
authors.initials: KS
authors.lastname: Foster
authors.forename: G P
authors.initials: GP
authors.lastname: Graber
mesh_terms: D000818:Animals; D002058:Burns, Electric / Q000209:etiology / Q000517:prevention & control*; D004554:Electric Countershock / Q000009:adverse effects* / Q000295:instrumentation; D017097:Electric Impedance; D004566:Electrodes; D004867:Equipment Design; D012881:Skin Temperature; D013552:Swine