摘要 |
A cardiac rhythm management device predicts defibrillation thresholds without any need to apply defibrillation shocks or subjecting the patient to fibrillation. Intravascular defibrillation electrodes are implanted in a heart. By applying a small test energy, an electric field near one of the defibrillation electrodes is determined by measuring a voltage at a sensing electrode offset from the defibrillation electrode by a known distance. A desired predetermined minimum value of electric field at the periphery of the heart is established. A distance between one of the defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode located at or near the heart periphery. Using the measured electric field and the measured distance to the periphery of the heart, the defibrillation energy needed to obtain the desired electric field at the heart periphery is estimated. This estimation is based on an elliptical model of the electric field distribution around the dipole foci formed by the defibrillation electrodes, or other suitable electric field model.
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