Measuring implantable cardioverter defibrillators (ICDs) during implantation surgery: Verification of a simulation

Implantable cardioverter defibrillators (ICDs) are increasing used in abnormal configurations. We have developed a patient specific forward simulation model to predict efficacy of the defibrillation shock. Our goal was to develop a method of measuring the ICD surface potentials as the devices are tested during implantation surgery to use as verification of the simulation. A lead selection algorithm was used to develop a surface potential mapping system with 32 recording sites that do not interfere with implantation surgery. ICD discharge recordings were compared at similar locations to corresponding patient models. The reconstructed simulated surface potentials showed <1%error, demonstrating an effective algorithm to recreate the potential distribution of an ICD. The reconstructed surface recordings showed errors in the magnitude of the potentials, yet demonstrated high correlation when compared to the simulation. Though refinement is needed, the simulation shows proper distribution of ICD potentials.