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Subcutaneous defibrillator

Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
Susanne Röger, Stefanie L Rosenkaimer, Anna Hohneck, Siegfried Lang, Ibrahim El-Battrawy, Boris Rudic, Erol Tülümen, Ksenija Stach, Jürgen Kuschyk, Ibrahim Akin, Martin Borggrefe
BACKGROUND: The wearable cardioverter-defibrillator (WCD) has emerged as a valuable tool to temporarily protect patients at risk for sudden cardiac death (SCD). The aim of this study was to determine the value of the WCD for therapy optimization of heart failure patients. METHODS: One hundred five consecutive patients that received WCD between 4/2012 and 9/2016 were included in the study. All patients were followed for clinical outcome and echocardiographic parameters during WCD therapy and had continued follow-up after WCD therapy, irrespective of subsequent implantable cardioverter-defibrillator (ICD) implantation...
March 15, 2018: BMC Cardiovascular Disorders
Carmen Adduci, Francesca Palano, Pietro Francia
The trans-venous implantable cardioverter defibrillator (TV-ICD) is effective in treating life-threatening ventricular arrhythmia and reduces mortality in high-risk patients. However, there are significant short- and long-term complications that are associated with intravascular leads. These shortcomings are mostly relevant in young patients with long life expectancy and low risk of death from non-arrhythmic causes. Drawbacks of trans-venous leads recently led to the development of the entirely subcutaneous implantable cardioverter defibrillator (S-ICD)...
March 11, 2018: Journal of Clinical Medicine
Nikolay Bogush, Raul E Espinosa, Bryan C Cannon, Philip L Wackel, Hideo Okamura, Paul A Friedman, Christopher J McLeod
No abstract text is available yet for this article.
March 8, 2018: International Journal of Cardiology
Cindy You, Shishir Sharma, Aakash Bavishi, Christopher A Groh, Yazan Alia, Basil Saour, Rod Passman
BACKGROUND: Hemodialysis (HD) patients have a high risk of sudden death but limited vascular access and high complication rates from transvenous implantable cardioverter-defibrillators (ICDs). Subcutaneous ICDs (S-ICD) may be an alternative, but dynamic ECG changes may result in inappropriate shocks. This study aims to define the screen failure rate for S-ICD in patients pre- and post-HD. METHODS: ECG waveforms were obtained using electrodes mimicking the S-ICD sensing vectors in an unselected test group of chronic HD patients and a control group of ICD-eligible non-dialysis patients...
March 10, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Pietro Francia, Matteo Ziacchi, Paolo De Filippo, Stefano Viani, Antonio D'Onofrio, Vincenzo Russo, Carmen Adduci, Mauro Biffi, Paola Ferrari, Valter Bianchi, Ernesto Ammendola, Francesca Palano, Jessica Frisoni, Sergio Valsecchi, Mariolina Lovecchio, Maria Grazia Bongiorni
PURPOSE: Since subcutaneous implantable cardioverter defibrillator (S-ICD) introduction, the pre-implant screening based on a dedicated manual ECG tool (MST) was required to assure adequate sensing by the S-ICD. A novel automated screening tool (AST) has been recently developed. We assessed and compared the pass rate with AST and MST, and we measured the agreement between screening tools. METHODS: Three electrodes were positioned at locations mimicking the placement of the S-ICD, and ECG recordings were collected in the supine and standing postures at rest...
March 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Andrea Droghetti, Erika Basso Ricci, Paolo Scimia, Fabiola Harizai, Massimiliano Marini
BACKGROUND: The standard technique for implanting a subcutaneous defibrillator (S-ICD) requires three incisions and the pocket of the device is created in the subcutaneous tissue of the left lateral thoracic wall. However, a two-incision technique may be adopted, in which the cranial parasternal region is avoided and the device is positioned more deeply, completely under the latissimus dorsi muscle. This can also be combined with Ultrasound-Guided Serratus Anterior Plane Block (US-SAPB) for intraoperative anesthesia and perioperative analgesia...
March 1, 2018: Pacing and Clinical Electrophysiology: PACE
Shu C Chang, Kristen K Patton, Melissa R Robinson, Jeanne E Poole, Jordan M Prutkin
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires pre-implant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12 lead ECG machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. METHODS: Subjects were recruited if they had a transvenous single lead ICD without pacing requirements or were candidates for a new ICD...
February 24, 2018: Pacing and Clinical Electrophysiology: PACE
K P Letsas, S Xydonas, N Karamichalakis, M Efremidis, D Manolatos, G Bazoukis, D Asvestas, K Vlachos, S Georgopoulos, A Saplaouras, J Winter, A Sideris
BACKGROUND: The conventional technique for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation has been associated with pocket complications. The aim of this study was to evaluate the efficacy and safety of an alternative intermuscular technique for S‑ICD implantation. METHODS: S-ICDs were implanted in ten consecutive patients (ten males, mean age: 46.8 ± 14.7 years). The pocket for the pulse generator was made above the serratus anterior muscular fascia and beneath the latissimus dorsi muscle by detaching the fibrous tissue between the muscles...
February 21, 2018: Herz
Daniel J Friedman, Craig S Parzynski, E Kevin Heist, Andrea M Russo, Joseph G Akar, James V Freeman, Jeptha P Curtis, Sana M Al-Khatib
Background -Compared to transvenous (TV) implantable cardioverter defibrillators (ICD), subcutaneous (S) ICDs require a higher energy for effective defibrillation. Although ventricular fibrillation (VF) conversion testing (CT) is recommended after S-ICD implantation to ensure an adequate margin between the defibrillation threshold and maximum device output (80J), prior work found that adherence to this recommendation is declining. Methods -We studied first time S-ICD recipients (between September 28, 2012 and April 1, 2016) in the National Cardiovascular Database Registry ICD Registry to determine: predictors of use of CT, predictors of an insufficient safety margin (ISM, defined as VF conversion energy >65J) during testing, and in-hospital outcomes associated with use of CT...
February 20, 2018: Circulation
Anne-Floor B E Quast, Fleur V Y Tjong, Brendan E Koop, Arthur A M Wilde, Reinoud E Knops, Martin C Burke
Aims: The development of communicating modular cardiac rhythm management systems relies on effective intrabody communication between a subcutaneous implantable cardioverter-defibrillator (S-ICD) and a leadless pacemaker (LP), using conducted communication. Communication success is affected by the LP and S-ICD orientation. This study is designed to evaluate the orientation of the LP and S-ICD in canine subjects and measure success and threshold of intrabody communication. To gain more human insights, we will explore device orientation in LP and S-ICD patients...
February 14, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Krzysztof Ozierański, Marcin Michalak, Agata Tymińska, Paweł Balsam, Marcin Grabowski
No abstract text is available yet for this article.
2018: Kardiologia Polska
Marc A Miller, Himani V Bhatt, Menachem Weiner, Tom F Brouwer, Alexander J Mittnacht, Ali Shariat, Christina Jeng, Caroline Eden, Hung-Mo Lin, Benjamin Salter, Srinivas R Dukkipati, Vivek Y Reddy
No abstract text is available yet for this article.
February 14, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Shozo Konishi, Hitoshi Minamiguchi, Kentaro Ozu, Hiroya Mizuno, Shungo Hikoso, Osamu Yamaguchi, Yasushi Sakata
Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are susceptible to T-wave oversensing (TWOS) caused by high rate-dependent QRS-T morphology changes. We experienced an inappropriate S-ICD shock due to TWOS, which could not be predicted by routine exercise testing. A newly available high-pass filter might be effective for avoiding this.
February 2018: Clinical Case Reports
Yuka Taguchi, Toshiyuki Ishikawa, Katsumi Matsumoto, Yutaka Ogino, Hirooki Matsushita, Kohei Iguchi, Junya Hosoda
A 17-year-old woman was resuscitated from cardiac arrest due to ventricular fibrillation and was diagnosed with concealed long QT syndrome. She underwent subcutaneous implantable cardiac defibrillator (S-ICD) implantation at our hospital. The device electrogram immediately after implantation was normal. Four days after implantation, she received an inappropriate shock. The device interrogation revealed a continuous baseline shift and frequent oversensing for low amplitude signals, followed by a shock. A chest radiograph in the orthogonal view showed entrapped subcutaneous air surrounding the distal electrode...
February 14, 2018: International Heart Journal
Robert Larbig, Markus Bettin, Lukas J Motloch, Alicia Fischer, Niklas Bode, Gerrit Frommeyer, Florian Reinke, Andreas Loeher, Lars Eckardt, Julia Köbe
Inappropriate shocks are a feared complication after implantable cardioverter-defibrillator (ICD) implantation and have a tremendous impact on quality of life. Inappropriate shocks in patients with subcutaneous ICD (S-ICD®, Boston Scientific, Marlborough, MA, USA) have various underlying causes. This review summarizes the current literature on this topic and lists possible treatment options.
February 12, 2018: Herzschrittmachertherapie & Elektrophysiologie
Serge Boveda, Radoslaw Lenarczyk, Stefano Fumagalli, Roland Tilz, Kinga Goscinska-Bis, Maciej Kempa, Pascal Defaye, Christelle Marquié, Alessandro Capucci, Laura Ueberham, Nikolaos Dagres
The purpose of this European Heart Rhythm Association (EHRA) prospective snapshot survey is to provide an overview of the factors influencing patient selection for the implantation of a particular type of device: subcutaneous implantable cardioverter-defibrillator (S-ICD) or transvenous implantable cardioverter-defibrillator (TV-ICD), across a broad range of tertiary European centres. A specially designed electronic questionnaire was sent via the internet to tertiary reference centres routinely implanting both TV-ICDs and S-ICDs...
February 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Stephen Duffett, Imane El Hajjaji, Jaimie Manlucu, Raymond Yee
Defibrillation testing (DFT) during implantable cardioverter-defibrillator (ICD) implantation is still considered standard of care in some, but in increasingly fewer centers. The goal is to ensure that the device system functions as intended by testing in the controlled laboratory setting. Although safe, complications can occur and DFT is associated with an increased procedural time and cost. DFT is useful in assessing device function when programming changes or patient characteristics raise concerns regarding ICD efficacy...
March 2018: Cardiac Electrophysiology Clinics
Sit-Yee Kwok, Nicholson Yam, Kin-Shing Lun, Robin Hs Chen, Timmy Wk Au, Tak-Cheung Yung
No abstract text is available yet for this article.
February 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Serge Boveda, Marijke C Laarakker, Christèle Cardin, Jean-Paul Albenque
No abstract text is available yet for this article.
January 2018: HeartRhythm Case Reports
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