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Conditions for the indirect transesophageal atrial stimulation (TAS), useful for cardiac diagnosis and treatment, are optimized both by way of clinical experiment and a computer modelling. The paper demonstrates the results of comparison of electric current density, obtained on the surface of the left atrium during computer modelling, with the results of our own experiments. An evaluation was made with the use of spiral CT scanning of the distance between the esophagus and the posterior wall of the left atrium. The average distance in the tested group of 27 subjects was 4.7 ±σ = 1.1 mm. During transesophageal stimulation, we have determined the average excitation threshold of the left atrium, obtaining the value 5.5 ±σ = 1.8 mA in the examined group of 27 patients. The calculated average current density on the surface of left atrium for the selective electrode with point poles used in the experiment amounted to 39.6 μA/mm2. Electric current densities obtained by other researchers by means of computer modelling for omnidirectional and selective ring electrodes turned out to be much lower after adjustment to similar conditions, which was the result of electrically active larger sizes surfaces of the poles of electrodes used in the modelling.
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Tom
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243--249
Opis fizyczny
Bibliogr. 14 poz., rys., tab.
Twórcy
autor
- Institute of Medical Technology and Equipment ITAM, Roosevelta 118 Street, 41-800 Zabrze.
autor
- Institute of Medical Technology and Equipment ITAM, Roosevelta 118 Street, 41-800 Zabrze.
autor
- Department of Anesthesiology and Intensive Care, A. Mielecki Clinical Hospital, Medical University of Silesia, Katowice, Poland.
autor
- Laboratory of Diagnostic Imaging, St. Leszczynski Hospital, Katowice, Poland
Bibliografia
- [1] ARZBAECHER R., JENKINS J. M., A Review of the Theoretical and Experimental Bases of Transesophageal Atrial Pacing. Journal of Electrocardiology 2002, Vol. 35 Supplement, pp. 137-141.
- [2] CRAWFORD TM, DICK M 2nd, BANK E, JENKINS JM., Transesophageal atrial pacing: importance of the atrial-esophageal relationship. Med Instrum. 1986, Jan-Feb; 20(1):40-44.
- [3] FROMER M., SHENASA M., Ultrarapid Subthreshold Stimulation for Termination of Atrioventricular Node Reentrant Tachycardia. JACC 1992, Vol. 20, No. 4 October:879-83.
- [4] KRASTEVA V., Finite Element Modeling Approach for Optimal Electrode Configuration in Atrial Pacing, Computers in Cardiology, 2003, 30:441-444.
- [5] LACKOVIC I., MAGJAREVIC R., Analysis of Current Density Distribution during Transesophageal Pacing Using the Finite-Element Model. World Congress on Medical Physics and Biomedical Engineering 2006, IFMBE Proceedings 2007, Volume 14, Part 16, pp. 2673-2676.
- [6] LACKOVIC I., MAGJAREVIC R., Computer Simulation Of Transesophageal Pacing With Conventional And Selective Leads Using 3-D Models. 3rd European Medical and Biological Engineering Conference EMBEC, 2005, IFMBE Proceedings 2005, Vol. 11, pp. 2864-2869.
- [7] PATTISON C. Z., ATLEE J. L., MATHEWS E. L., BULJUBASIC N., ENTRESS J. J., Atrial pacing thresholds measured in anesthetized patients with the use of an esophageal stethoscope modified for pacing. Anesthesiology 1991, 74:854-859.
- [8] PROCHACZEK F., GALECKA J., Transesophageal cardiac stimulation: properties of ring electrodes lead and point-direction electrodes one, Part I, Kard. Pol. 1988, 32:683-690 (in Polish).
- [9] PROCHACZEK F., GALECKA J., STANEK K., STOPCZYK M., New diagnostic prospects for transesophageal pacing of the heart on the basis of an esophageal atrial electrogram received during stimulation, Stimucoeur. 1986, 14:159-165.
- [10] PROCHACZEK F., GALECKA J., STOPCZYK M., A method of esophageal electrogram recording for diagnostic atrial and ventricular pacing, PACE 1990, 13:1136-1141.
- [11] PROCHACZEK F., GALECKA J., STOPCZYK M., Cardiac transesophageal pacing: value of artifacts suppression circuit of pacing impulse for quality of ECG tracing recorded from pacing transesophageal electrode, Part III, Kard. Pol. 1989, 32:379-385 (in Polish).
- [12] PROCHACZEK F., WODNIECKI J., Evaluation of oesophageal left atrial stimulation for the diagnosis of coronary artery disease, Wiad. Lek., 1977, Vol. 30, pp. 593–598 (in Polish).
- [13] PROCHACZEK F., WODNIECKI J., MAZANEK-SZYMANSKA E., Transesophageal left atrial stimulation for revealing additional pathways of atrioventricular conduction, Pol. Tyg. Lek. 1979, 34:1073-1076 (in Polish).
- [14] ROTH J. V., BRODY J. D., DENHAM E. J., Positioning the pacing esophageal stethoscope for transesophageal atrial pacing without P-wave recording: implications for transesophageal ventricular pacing. Anest Analg 1996, 83:48-54.
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Bibliografia
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