Variability in high-voltage impedance: an exploratory case study on
human specimens
Abstract
We aimed to evaluate the effect of defibrillator component positioning
on high-voltage impedance. In two human specimens with BMI 19.1 kg/m
2 and 31.4 kg/m 2, shocks were
administered with a subcutaneous implantable cardioverter-defibrillator
(S-ICD) and an automated external defibrillator placed in various
positions. High-voltage impedance increased with more fat tissue between
the defibrillator components, or with air in the subcutaneous pocket of
the S-ICD. High-voltage impedance was lowest when defibrillator
components were placed anteriorly, but due to adjacent positioning, the
electrical current will not be transmitted through the myocardium and
effective defibrillation is unlikely. In conclusion, positioning of
defibrillator components greatly affects high-voltage impedance, but the
course of the current should always be considered.