Evidence map›Paper›PMID 28736750›Full record

ArticleJACC. Clinical electrophysiology2017

A Novel Defibrillation Tool: Percutaneously Delivered, Partially Insulated Epicardial Defibrillation.

Ammar M Killu, Niyada Naksuk, Zdeněk Stárek, Christopher V DeSimone, Faisal F Syed, Prakriti Gaba, Jiří Wolf, Frantisek Lehar, Martin Pesl, Pavel Leinveber and 11 more

Abstract read
In one paragraph

Article in JACC. Clinical electrophysiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Non-traditional implantable cardioverter-defibrillator configurations and insertion techniques: a review of contemporary options.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022
    Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 5 institutions in 2 countries.

Ammar M KilluDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Niyada NaksukDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Zdeněk StárekDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Christopher V DeSimoneDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Faisal F SyedDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Prakriti GabaMayo Medical School, Rochester, MN.
Jiří WolfDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Frantisek LeharDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Martin PeslDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Pavel LeinveberDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Michal CrhaUniversity of Veterinary and Pharmaceutical Sciences Brno, Czech Republic.
Dorothy LadewigMayo Clinic Ventures, Rochester, MN.
Joanne PowersDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
Scott SuddendorfDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
David O HodgeDepartment of Health Science Research, Mayo Clinic, Jacksonville, FL.
Gaurav SatamMayo Clinic Ventures, Rochester, MN.
Miroslav NovákDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Tomas KaraDepartment of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Charles J BruceDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Paul A FriedmanDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Samuel J AsirvathamDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Mayo Clinic · USUniversity Hospital Brno · CZMayo Clinic in Arizona · USJacksonville College · USUniversity of Veterinary Sciences Brno · CZ

Funding

CARDIOVASOLOGYT32HL007111 · NHLBI · MAYO CLINIC ROCHESTER · PI Barry A. Borlaug · 1985 to 2026
$8.7M
NHLBI NIH HHS T32 HL007111
6 · The paper itself

Abstract

introductionEpicardial defibrillation systems currently require surgical access. We aimed to develop a percutaneous defibrillation system with partially-insulated epicardial coils to focus electrical energy on the myocardium and prevent or minimize extra-cardiac stimulation.

methodsWe tested 2 prototypes created for percutaneous introduction into the pericardial space via a steerable sheath. This included a partially-insulated defibrillation coil and a defibrillation mesh with a urethane balloon acting as an insulator to the face of the mesh not in contact with the epicardium. The average energy associated with a chance of successful defibrillation 75% of the time (ED75) was calculated for each experiment.

resultsOf 16 animal experiments, 3 pig experiments had malfunctioning mesh prototypes such that results were unreliable; these were excluded. Therefore, 13 animal experiments were analyzed - 6 canines (29.8±4.0kg); 7 pigs (41.1±4.4kg). The overall ED75 was 12.8±6.7J (10.9±9.1J for canines; 14.4±3.9J in pigs [P=0.37]). The lowest ED75 obtained in canines was 2.5J while in pigs it was 9.5J. The lowest energy resulting in successful defibrillation was 2J in canines and 5J in pigs. There was no evidence of coronary vessel injury or trauma to extra-pericardial structures.

conclusionPercutaneous, epicardial defibrillation using a partially insulated coil is feasible and appears to be associated with low defibrillation thresholds. Focusing insulation may limit extra-cardiac stimulation and potentially lower energy requirements for efficient defibrillation.

Indexed as

DefibrillatorsAnimalsDogsElectric CountershockFemaleMalePericardiumSwinearrhythmiadefibrillationepicardialICDinsulationpercutaneous

Identifiers

PMID28736750
PMCPMC5517050
OpenAlexW2598593079

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.