Electrical behavior of defibrillation and pacing electrodes

This article discusses the electrodes and their interfaces for internal and external defibrillation and external pacing applications. Of primary concern is the nature of the current delivery and distribution at the electrode-tissue interface and the techniques that may be used to generate a uniform distribution of current density in order to minimize pain and burning. The cost of achieving a uniform current distribution is tolerable for external pacing applications, but questionable for defibrillation applications. In the process of examining the nature of the electrode interface, we also discuss various models of its behavior, including analytic, equivalent circuit, numerical, and empirical models.

[1]  K. Yee.  Numerical solution of initial boundary value problems involving maxwell's equations in isotropic media , 1966 .

[2]  H. Fricke,et al.  XXXIII. The theory of electrolytic polarization , 1932 .

[3]  E. Warburg,et al.  Ueber das Verhalten sogenannter unpolarisirbarer Elektroden gegen Wechselstrom , 1899 .

[4]  Yongmin Kim,et al.  Optimal Electrode Designs for Electrosurgery, Defibrillation, and External Cardiac Pacing , 1986, IEEE Transactions on Biomedical Engineering.

[5]  George A. Johnson,et al.  Transvenous defibrillation in humans via the coronary sinus. , 1990, Circulation.

[6]  R. Holland.  Finite-Difference Solution of Maxwell's Equations in Generalized Nonorthogonal Coordinates , 1983, IEEE Transactions on Nuclear Science.

[7]  J. G. Webster,et al.  Analysis and Control of the Current Distribution under Circular Dispersive Electrodes , 1982, IEEE Transactions on Biomedical Engineering.

[8]  L. Jordaens,et al.  A Subcutaneous Lead Array for Implantable Cardioverter Defibrillators , 1993, Pacing and clinical electrophysiology : PACE.

[9]  George A. Johnson,et al.  A Simplified, Single‐Lead Unipolar Transvenous Cardioversion‐Defibrillation System , 1993, Circulation.

[10]  J Hedley-Whyte,et al.  The Distribution of Radiofrequency Current and Burns , 1973, Anesthesiology.

[11]  Yongmin Kim,et al.  Optimal Electrode Configurations for External Cardiac Pacing and Defibrillation: An Inhomogeneous Study , 1987, IEEE Transactions on Biomedical Engineering.

[12]  H P Schwan,et al.  ELECTRODE POLARIZATION IMPEDANCE AND MEASUREMENTS IN BIOLOGICAL MATERIALS * , 1968, Annals of the New York Academy of Sciences.

[13]  Chi Hou Chan,et al.  A finite‐difference time‐domain method using whitney elements , 1994 .

[14]  D. Panescu,et al.  Optimization of cardiac defibrillation by three-dimensional finite element modeling of the human thorax , 1995, IEEE Transactions on Biomedical Engineering.

[15]  D. Panescu,et al.  A nonlinear electrical-thermal model of the skin , 1994, IEEE Transactions on Biomedical Engineering.

[16]  Yongmin Kim,et al.  Computational studies of transthoracic and transvenous defibrillation in a detailed 3-D human thorax model , 1995, IEEE Transactions on Biomedical Engineering.

[17]  Yongmin Kim,et al.  Predicting cardiothoracic voltages during high energy shocks: methodology and comparison of experimental to finite element model data , 1995, IEEE Transactions on Biomedical Engineering.

[18]  J J Bocka,et al.  External transcutaneous pacemakers. , 1989, Annals of emergency medicine.

[19]  S. Sharkey,et al.  Prophylactic external pacing during cardioversion of atrial tachyarrhythmias. , 1985, The American journal of cardiology.

[20]  J. G. Webster,et al.  Distributed Equivalent-Circuit Models for Circular Dispersive Electrodes , 1982, IEEE Transactions on Biomedical Engineering.

[21]  D. Panescu,et al.  A nonlinear finite element model of the electrode-electrolyte-skin system , 1994, IEEE Transactions on Biomedical Engineering.