Low-Energy Endocardial Defibrillation Using Dual, Triple, and Quadruple Electrode Systems

Abstract The feasibility of achieving both universal application of nonthoracotomy leads and low (≤15 J) defibrillation energy requirements by optimizing lead system configuration for use with low-output ( 1 electrode configuration at 10 J, whereas only 53% of successful patients could be reverted at >1 electrode configuration at 5 J (p This study examines the feasibility of achieving both universal application of nonthoracotomy leads and low (≤15 J) defibrillation energy requirements by optimizing 5 different lead system configurations. Reduction in mean defibrillation threshold to 5.6 ± 3.6 J could be observed, which allowed pulse generators with a maximum output of ≤25 J and yet maintained an adequate safety margin in all patients.