Abstract
A catheter with a conductive wall should enhance patient protection against electrically induced ventricular fibrillation by leaking away externally applied current before it reaches the catheter tip. The hypothesis was tested in five dogs (81 attempts), applying up to 130 V, 60 Hz proximally, using conductive and nonconductive catheters of identical configuration. Fibrillation could not be induced with saline-filled conductive catheters, but the nonconductive catheters usually caused fibrillation. As anticipated, use of a conductive guidewire resulted in fibrillation with both catheter types. A mathematical analysis of catheter behavior is presented which agrees with bench data. Practical implications of the theory include logarithmic attenuation of tip current with increasing immersed length, and a simple means of verifying catheter characteristics. The present instrumentation leakage current limit for invasive measurements is not completely satisfactory, since it increases instrumentation costs without assurance that threshold values will not be exceeded due to other uncontrolled sources. The conductive catheter appears to offer a better alternative by altering the common current pathway, so that a larger, more reliably achievable external leakage current limit could be safely specified.
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Chen, P., Myers, G. H., Parsonnet, V., Chatterjee, K., and Katz, P. Relationship between pacemaker fibrillation thresholds and electrode area.Medical Instrumentation 1975,9, 165–170.
Dalziel, C. F. Lethal electrical currents.IEEE Spectrum February 1969, 44–50.
Forsythe, W. E.Smithsonian physical tables. Washington, D.C.: Smithsonian Institution Press, 1969.
Geddes, L. A., and Baker, L. E. Response to passage of electric current through the body.Journal of the Association for the Advancement of Medical Instrumentation 1971,5, 13–18.
Geddes, L. A., Cabler, P., Moore, A. G., Rosborough, J., and Tacker, W. A. Threshold 60-Hz current required for ventricular fibrillation in subjects of various body weights.IEEE Transactions on Biomedical Engineering 1973,BME-20, 465–468.
Geselowitz, D. B. Comments on “Threshold 60-Hz current required for ventricular fibrillation in subjects of various body weights”.IEEE Transactions on Biomedical Engineering 1974,BME-21, 493–494.
Green, H. L., Raftery, E. B., and Gregory, I. C. Ventricular fibrillation threshold of healthy dogs to 50-Hz current in relation to earth leakage currents of electromedical equipment.Biomedical Engineering (London) 1972,7, 408–414.
Kahn, A. R., and Stroebel, F. A.Catheter apparatus. U.S. Patent 3,659,588, 1972.
Kugelberg, J. Accidental ventricular fibrillation of the human heart.Scandinavian Journal of Thoracic and Cardiovascular Surgery 1975,9, 133–139.
Lee, W. R., and Scott, J. R. Thresholds of fibrillating leakage currents along intracardiac catheters: an experimental study.Cardiovascular Research 1973,7, 495–500.
McIntosh, H. D., Starmer, F., and Whalen, R. E. A comparison of the electrical ventricular fibrillation threshold with and without anesthesia.American Heart Journal 1966,72, 419–420.
Mosenkis, R. (Ed.). Leakage current limits. InHealth Devices. January 1974. Pp. 21–23.
Raftery, E. B., Green, H., and Gregory, I. Electrical safety: fibrillation thresholds with 50 Hz leakage currents in man and animals.British Heart Journal 1973,35, 864.
Roy, O. Z. 60 Hz ventricular fibrillation and rhytm thresholds and the nonpacing intracardiac catheter.Medical and Biological Engineering 1975,13, 228–234.
Roy, O. Z., Park, G. C., and Scott, J. R. Intracardiac catheter fibrillation thresholds as a function of current flow duration and electrode area. InAnnual conference engineering in medicine and biology. 1976a. Vol. 29, p. 27.
Roy, O. Z., Scott, John R., and Park, G. C. 60 Hz ventricular fibrillation and pump failure thresholds versus electrode area.IEEE Transactions Biomedical Engineering 1976b,23, 45–48.
Scott, J. R., Lee, W. R., and Zoledziowski, S. Ventricular fibrillation threshold for AC shocks of long duration, in dogs with normal acid-base state.British Journal of Industrial Medicine 1973,30, 155–161.
Snider, D. Electrical threshold of cardiac fibrillation in humans.Medical Instrumentation 1973,7, 80.
Starmer, C. F., and Whalen, R. E. Current density and electrically induced ventricular fibrillation.Medical Instrumentation 1973,7, 158–161.
Sugimoto, T., Schaal, S. F., and Wallace, A. G. Factors determining vulnerability to ventricular fibrillation induced by 60-cps alternating current.Circulation Research 1967,21, 601–608.
Vanremoortere, E. Production of ventricular fibrillation in dogs by A. C. Stimuli of long duration: prefibrillatory and transitional patterns.Acta Cardiologica 1968,23, 23–67.
Watson, A. B., Wright, J. S., and Loughman, J. Electrical thresholds for ventricular fibrillation in man.Medical Journal of Australia 1973,1, 1179–1182.
Weinberg, D. I., Artley, J. L., Whalen, R. E., and McIntosh, H. D. Electric shock hazards in cardiac catheterization.Circulation Research 1962,11, 1004–1009.
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Ream, A.K., Lipton, M.J. & Hyndman, B.H. Reduced risk of cardiac fibrillation with use of a conductive catheter. Ann Biomed Eng 5, 287–301 (1977). https://doi.org/10.1007/BF02407875
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DOI: https://doi.org/10.1007/BF02407875