Finite element modeling of subcutaneous implantable defibrillator electrodes in an adult torso. Jolley, M., Stinstra, J., Tate, J., Pieper, S., MacLeod, R., Chu, L., Wang, P., & Triedman, J. j-HR, 7(5):692–698, May, 2010. bibtex @Article{RSM:Jol2010,
author = "M. Jolley and J. Stinstra and J. Tate and S. Pieper and
R.S. MacLeod and L. Chu and P. Wang and J.K. Triedman",
title = "Finite element modeling of subcutaneous implantable
defibrillator electrodes in an adult torso.",
journal = j-HR,
year = 2010,
month = "May",
volume = 7,
number = 5,
pages = "692--698",
robnote = "BACKGROUND: Total subcutaneous implantable subcutaneous
defibrillators are in development, but optimal electrode
configurations are not known. OBJECTIVE: We used
image-based finite element models (FEM) to predict the
myocardial electric field generated during defibrillation
shocks (pseudo-DFT) in a wide variety of reported and
innovative subcutaneous electrode positions to determine
factors affecting optimal lead positions for subcutaneous
implantable cardioverter-defibrillators (S-ICD). METHODS:
An image-based FEM of an adult man was used to predict
pseudo-DFTs across a wide range of technically feasible
S-ICD electrode placements. Generator location, lead
location, length, geometry and orientation, and spatial
relation of electrodes to ventricular mass were
systematically varied. Best electrode configurations were
determined, and spatial factors contributing to low
pseudo-DFTs were identified using regression and general
linear models. RESULTS: A total of 122
single-electrode/array configurations and 28
dual-electrode configurations were simulated. Pseudo-DFTs
for single-electrode orientations ranged from 0.60 to 16.0
(mean 2.65 +/- 2.48) times that predicted for the base
case, an anterior-posterior configuration recently tested
clinically. A total of 32 of 150 tested configurations
(21\%) had pseudo-DFT ratios </=1, indicating the
possibility of multiple novel, efficient, and clinically
relevant orientations. Favorable alignment of
lead-generator vector with ventricular myocardium and
increased lead length were the most important factors
correlated with pseudo-DFT, accounting for 70\% of the
predicted variation (R(2) = 0.70, each factor P < .05) in
a combined general linear model in which parameter
estimates were calculated for each factor. CONCLUSION:
Further exploration of novel and efficient electrode
configurations may be of value in the development of the
S-ICD technologies and implant procedure. FEM modeling
suggests that the choice of configurations that maximize
shock vector alignment with the center of myocardial mass
and use of longer leads is more likely to result in lower
DFT.",
pmcid = "PMC3103844",
bibdate = "Tue May 25 06:09:13 2010",
}
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{"_id":"dTNKoM69JixQ2ezpt","bibbaseid":"jolley-stinstra-tate-pieper-macleod-chu-wang-triedman-finiteelementmodelingofsubcutaneousimplantabledefibrillatorelectrodesinanadulttorso-2010","downloads":0,"creationDate":"2016-07-01T21:38:35.415Z","title":"Finite element modeling of subcutaneous implantable defibrillator electrodes in an adult torso.","author_short":["Jolley, M.","Stinstra, J.","Tate, J.","Pieper, S.","MacLeod, R.","Chu, L.","Wang, P.","Triedman, J."],"year":2010,"bibtype":"article","biburl":"http://www.sci.utah.edu/~macleod/Bibtex/biglit.bib","bibdata":{"bibtype":"article","type":"article","author":[{"firstnames":["M."],"propositions":[],"lastnames":["Jolley"],"suffixes":[]},{"firstnames":["J."],"propositions":[],"lastnames":["Stinstra"],"suffixes":[]},{"firstnames":["J."],"propositions":[],"lastnames":["Tate"],"suffixes":[]},{"firstnames":["S."],"propositions":[],"lastnames":["Pieper"],"suffixes":[]},{"firstnames":["R.S."],"propositions":[],"lastnames":["MacLeod"],"suffixes":[]},{"firstnames":["L."],"propositions":[],"lastnames":["Chu"],"suffixes":[]},{"firstnames":["P."],"propositions":[],"lastnames":["Wang"],"suffixes":[]},{"firstnames":["J.K."],"propositions":[],"lastnames":["Triedman"],"suffixes":[]}],"title":"Finite element modeling of subcutaneous implantable defibrillator electrodes in an adult torso.","journal":"j-HR","year":"2010","month":"May","volume":"7","number":"5","pages":"692–698","robnote":"BACKGROUND: Total subcutaneous implantable subcutaneous defibrillators are in development, but optimal electrode configurations are not known. OBJECTIVE: We used image-based finite element models (FEM) to predict the myocardial electric field generated during defibrillation shocks (pseudo-DFT) in a wide variety of reported and innovative subcutaneous electrode positions to determine factors affecting optimal lead positions for subcutaneous implantable cardioverter-defibrillators (S-ICD). METHODS: An image-based FEM of an adult man was used to predict pseudo-DFTs across a wide range of technically feasible S-ICD electrode placements. Generator location, lead location, length, geometry and orientation, and spatial relation of electrodes to ventricular mass were systematically varied. Best electrode configurations were determined, and spatial factors contributing to low pseudo-DFTs were identified using regression and general linear models. RESULTS: A total of 122 single-electrode/array configurations and 28 dual-electrode configurations were simulated. Pseudo-DFTs for single-electrode orientations ranged from 0.60 to 16.0 (mean 2.65 +/- 2.48) times that predicted for the base case, an anterior-posterior configuration recently tested clinically. A total of 32 of 150 tested configurations (21%) had pseudo-DFT ratios </=1, indicating the possibility of multiple novel, efficient, and clinically relevant orientations. Favorable alignment of lead-generator vector with ventricular myocardium and increased lead length were the most important factors correlated with pseudo-DFT, accounting for 70% of the predicted variation (R(2) = 0.70, each factor P < .05) in a combined general linear model in which parameter estimates were calculated for each factor. CONCLUSION: Further exploration of novel and efficient electrode configurations may be of value in the development of the S-ICD technologies and implant procedure. FEM modeling suggests that the choice of configurations that maximize shock vector alignment with the center of myocardial mass and use of longer leads is more likely to result in lower DFT.","pmcid":"PMC3103844","bibdate":"Tue May 25 06:09:13 2010","bibtex":"@Article{RSM:Jol2010,\n author = \"M. Jolley and J. Stinstra and J. Tate and S. Pieper and\n R.S. MacLeod and L. Chu and P. Wang and J.K. Triedman\",\n title = \"Finite element modeling of subcutaneous implantable\n defibrillator electrodes in an adult torso.\",\n journal = j-HR,\n year = 2010,\n month = \"May\",\n volume = 7,\n number = 5,\n pages = \"692--698\",\n robnote = \"BACKGROUND: Total subcutaneous implantable subcutaneous\n defibrillators are in development, but optimal electrode\n configurations are not known. OBJECTIVE: We used\n image-based finite element models (FEM) to predict the\n myocardial electric field generated during defibrillation\n shocks (pseudo-DFT) in a wide variety of reported and\n innovative subcutaneous electrode positions to determine\n factors affecting optimal lead positions for subcutaneous\n implantable cardioverter-defibrillators (S-ICD). METHODS:\n An image-based FEM of an adult man was used to predict\n pseudo-DFTs across a wide range of technically feasible\n S-ICD electrode placements. Generator location, lead\n location, length, geometry and orientation, and spatial\n relation of electrodes to ventricular mass were\n systematically varied. Best electrode configurations were\n determined, and spatial factors contributing to low\n pseudo-DFTs were identified using regression and general\n linear models. RESULTS: A total of 122\n single-electrode/array configurations and 28\n dual-electrode configurations were simulated. Pseudo-DFTs\n for single-electrode orientations ranged from 0.60 to 16.0\n (mean 2.65 +/- 2.48) times that predicted for the base\n case, an anterior-posterior configuration recently tested\n clinically. A total of 32 of 150 tested configurations\n (21\\%) had pseudo-DFT ratios </=1, indicating the\n possibility of multiple novel, efficient, and clinically\n relevant orientations. Favorable alignment of\n lead-generator vector with ventricular myocardium and\n increased lead length were the most important factors\n correlated with pseudo-DFT, accounting for 70\\% of the\n predicted variation (R(2) = 0.70, each factor P < .05) in\n a combined general linear model in which parameter\n estimates were calculated for each factor. CONCLUSION:\n Further exploration of novel and efficient electrode\n configurations may be of value in the development of the\n S-ICD technologies and implant procedure. FEM modeling\n suggests that the choice of configurations that maximize\n shock vector alignment with the center of myocardial mass\n and use of longer leads is more likely to result in lower\n DFT.\",\n pmcid = \"PMC3103844\",\n bibdate = \"Tue May 25 06:09:13 2010\",\n}\n\n","author_short":["Jolley, M.","Stinstra, J.","Tate, J.","Pieper, S.","MacLeod, R.","Chu, L.","Wang, P.","Triedman, J."],"key":"RSM:Jol2010","id":"RSM:Jol2010","bibbaseid":"jolley-stinstra-tate-pieper-macleod-chu-wang-triedman-finiteelementmodelingofsubcutaneousimplantabledefibrillatorelectrodesinanadulttorso-2010","role":"author","urls":{},"metadata":{"authorlinks":{}},"downloads":0,"html":""},"search_terms":["finite","element","modeling","subcutaneous","implantable","defibrillator","electrodes","adult","torso","jolley","stinstra","tate","pieper","macleod","chu","wang","triedman"],"keywords":[],"authorIDs":[],"dataSources":["5HG3Kp8zRwDd7FotB","5G2skx26SJtreWr4m"]}