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Jay A Montgomery, Jody M Orton, Christopher R Ellis
No abstract text is available yet for this article.
October 20, 2016: Journal of Cardiovascular Electrophysiology
Andrea Droghetti, Alessandro Locatelli, Bruno Casiraghi, Maurizio Malacrida, Michele Arupi, Mark Ragusa
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a safe alternative to transvenous ICD. We describe a submuscular S-ICD placement technique in a severely obese with an oversized chest. Submuscular configuration allows optimal system positioning and impendence values warranting a safe and effective shock transmission. This technique is safe and improves patients comfort.
October 2016: Clinical Case Reports
Martin Grett, Martin Christ, Hans-Joachim Trappe
BACKGROUND: Little is known about the incidence and risk factors for progression to pacemaker dependency or the need for cardiac resynchronization in typical patients with an implanted defibrillator with regard to an alternative implantation of a subcutaneous ICD (S-ICD). STUDY DESIGN AND METHODS: After retrospective analysis of 291 patients with first implantation of a transvenous single chamber ICD (VVI-ICD) from 2010-2016 and excluding those with an indication for pacemaker or lack of follow-up data, 121 patients were included and investigated with regard to the following endpoints: need for pacemaker stimulation, upgrade for cardiac resynchronization (CRT), and secondary occurrence and effectiveness of antitachycardia pacing (ATP)...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Claudia Schaarschmidt, Christof Kolb
The subcutaneous implantable defibrillator (S-ICD) has become an established tool for the prevention of sudden cardiac death. Based on its detection properties, the S‑ICD is essentially dependent on correct morphology discrimination of the QRS complex and avoidance of potential T‑wave sensing. We report on a patient who experienced multiple inappropriate S‑ICD shocks due to T‑wave oversensing in the setting of new onset of right bundle branch block. Strategies for the optimisation of the device programming are discussed...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Jason Huang, Kristen K Patton, Jordan M Prutkin
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel implanted defibrillator for the prevention of sudden cardiac death that avoids intravascular access. Use of this device is limited by its inability to provide backup pacing. Combined use of the S-ICD with a permanent pacemaker may be the optimal choice in certain situations though experience with the use of both devices together remains limited. METHODS: We reviewed our single center experience with the S-ICD from March 2011 to November 2015...
October 13, 2016: Pacing and Clinical Electrophysiology: PACE
Maciej Kempa, Szymon Budrejko, Grzegorz Raczak
No abstract text is available yet for this article.
October 1, 2016: Archives of Medical Science: AMS
Julia W Erath, Abdul Sami Sirat, Mate Vamos, Stefan H Hohnloser
Persistent left superior vena cava is known to be a challenging anatomic abnormality for transvenous cardiac device implantation. In the a case of a young man presenting with dilative cardiomyopathy with severely impaired left ventricular ejection fraction (LVEF) and second-degree atrioventricular block (AV block), cardiac resynchronization therapy (CRT) with defibrillator (CRT-D) implantation was indicated. A transvenous approach was attempted, but placement of the right ventricular lead was not successful due to anatomic abnormalities...
September 19, 2016: Herzschrittmachertherapie & Elektrophysiologie
Michael K Essandoh, Andrew J Otey, Mahmoud Abdel-Rasoul, Erica J Stein, Katja R Turner, Nicholas C Joseph, Emile G Daoud
BACKGROUND: To date, general anesthesia has been suggested as the preferred approach for implantation of a subcutaneous implantable cardioverter-defibrillator (S-ICD). The purpose of this study was to assess the use of monitored anesthesia care (MAC) for S-ICD implantation. The goals were to assess adequate sedation and analgesia (efficacy endpoints) and major perioperative airway or hemodynamic compromise (safety endpoints). The authors hypothesized that MAC may provide adequate sedation and analgesia and no major perioperative airway or hemodynamic compromise during S-ICD implantation and multiple defibrillation threshold (DFT) testing...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Daniel J Friedman, Craig S Parzynski, Paul D Varosy, Jordan M Prutkin, Kristen K Patton, Ali Mithani, Andrea M Russo, Jeptha P Curtis, Sana M Al-Khatib
Importance: Trends and in-hospital outcomes associated with early adoption of the subcutaneous implantable cardioverter defibrillator (S-ICD) in the United States have not been described. Objectives: To describe early use of the S-ICD in the United States and to compare in-hospital outcomes among patients undergoing S-ICD vs transvenous (TV)-ICD implantation. Design, Setting, and Participants: A retrospective analysis of 393 734 ICD implants reported to the National Cardiovascular Data Registry ICD Registry, a nationally representative US ICD registry, between September 28, 2012 (US Food and Drug Administration S-ICD approval date), and March 31, 2015, was conducted...
September 7, 2016: JAMA Cardiology
Serge Boveda, Radoslaw Lenarczyk, Kristina Haugaa, Stefano Fumagalli, Antonio Hernandez Madrid, Pascal Defaye, Paul Broadhurst, Nikolaos Dagres
AIMS: The purpose of this European Heart Rhythm Association (EHRA) survey is to provide an overview of the current use of subcutaneous cardioverter defibrillators (S-ICDs) across a broad range of European centres. METHODS AND RESULTS: A questionnaire was sent via the internet to centres participating in the EHRA electrophysiology research network. Questions included standards of care and policies used for patient management, indications, and techniques of implantation of the S-ICDs...
September 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Joshua D Levine, C Ellins, N Winn, Robert Kim, Steve S Hsu, John N Catanzaro
The subcutaneous implantable cardioverter defibrillator (S-ICD) registry included very few patients with a body mass index (BMI) greater than 40. We present a case of a 40-year-old male with a BMI of 44 and ejection fraction of 25% who underwent S-ICD implantation for primary prevention of sudden cardiac death in the setting of a nonischemic cardiomyopathy. Defibrillation threshold (DFT) testing failed at high output. A posterior to anterior radiograph demonstrated migration of the components despite positioning under fluoroscopy...
August 23, 2016: Cardiology
D G Wilson, G Leventigiannis, C Barr, J M Morgan
BACKGROUND: T wave oversensing (TWOS) is the commonest cause of inappropriate shocks in subcutaneous implantable cardioverter defibrillators (S-ICDs). We hypothesise that predictors of TWOS can be derived from surface ECG parameters. METHODS: In a cohort of SICD recipients in two UK centres, all patients who had TWOS (study group) were compared to all those who had not (control group). The pre-implant screen was scanned and the R wave, T wave amplitudes, QRS interval, time to peak T wave, QT interval and R:T ratio was measured using digital callipers...
October 1, 2016: International Journal of Cardiology
Paola Ferrari, Fabrizio Giofrè, Paolo De Filippo
The subcutaneous implantable cardioverter defibrillator (S-ICD) is a novel device now accepted in clinical practice for treating ventricular arrhythmias. In 14 consecutive patients, S-ICD devices were placed in the virtual space between the anterior surface of the serratus anterior muscle and the posterior surface of the latissimus dorsi muscle. During a mean follow up of 9 months, no dislocations, infections, hematoma formations, or skin erosions were observed. Intermuscular implantation of the S-ICD could be a reliable, safe, and appealing alternative to the standard subcutaneous placement...
June 2016: Journal of Arrhythmia
Mikhael F El-Chami, Bernard Harbieh, Mathew Levy, Angel R Leon, Faisal M Merchant
BACKGROUND: T wave oversensing (TWOS) is a major drawback of the subcutaneous implantable cardioverter defibrillator (S-ICD). Data on predictors of TWOS in S-ICD recipients are limited. We sought to investigate predictors of TWOS in a cohort of patients receiving an S-ICD at our institution. METHODS: S-ICD recipients at our center were identified retrospectively and stratified based on the presence or absence of TWOS. Clinical and electrocardiographic parameters were collected and compared between the 2 groups...
June 2016: Journal of Arrhythmia
Susanne S Pedersen, Mirjam H Mastenbroek, Nathan Carter, Craig Barr, Petr Neuzil, Marcoen Scholten, Pier D Lambiase, Lucas Boersma, Jens B Johansen, Dominic A M J Theuns
The first clinical results from the Evaluation of Factors Impacting Clinical Outcome and Cost Effectiveness of the subcutaneous implantable cardioverter defibrillator (EFFORTLESS S-ICD) Registry on the entirely S-ICD system are promising, but the impact of the S-ICD system on patients' quality of life (QoL) is not known. We evaluated the QoL of patients with an S-ICD against an unrelated cohort with a transvenous (TV)-ICD system during 6 months of follow-up. Consecutively implanted patients with an S-ICD system were matched with patients with a TV-ICD system on a priori selected variables including baseline QoL...
August 15, 2016: American Journal of Cardiology
Hans Rutzen-Lopez, Jose Silva, Robert H Helm
Since the initial introduction of pacemakers and defibrillators, the rapid growth in microcircuit and battery technology has increased the longevity demands and exposed the vulnerabilities of transvenous leads. Over a half of century later, leadless pacemaker and defibrillation systems are just reaching the clinical arena. Despite the remarkable advantages of leadless pacing systems, the data are still quite limited and broad implementation of these technologies need to occur in a cautious and deliberate fashion as the peri-procedural risks remains high...
August 2016: Current Treatment Options in Cardiovascular Medicine
Gerrit Frommeyer, Dirk G Dechering, Simon Kochhäuser, Markus Bettin, Julia Köbe, Lars Eckardt, Florian Reinke
BACKGROUNDS: The totally subcutaneous implantable defibrillator (S-ICD) has been designed as a new alternative to conventional implantable defibrillators. This system is especially attractive for young patients. However, long-term experience is not yet available. To address the question whether the S-ICD system is safe and feasible for young patients with electrical heart disease or idiopathic ventricular fibrillation (VF), the data of a standard of care prospective single center S-ICD registry were evaluated...
May 23, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Lorenzo Maria Santucci, Fabio Anselmo Saputo, Letizia Verticelli, Ilaria Tamburri, Silvia Placidi, Massimo Stefano Silvetti, Fabrizio Drago
No abstract text is available yet for this article.
August 2016: Pacing and Clinical Electrophysiology: PACE
Michael K Essandoh, Juan G Portillo, Raul Weiss, Andrew J Otey, Alix N Zuleta-Alarcon, Michelle L Humeidan, Jose L Torres, Antolin S Flores, Karina Castellon-Larios, Mahmoud Abdel-Rasoul, Michael J Andritsos, William J Perez, Erica J Stein, Katja R Turner, Galina T Dimitrova, Hamdy Awad, Sujatha P Bhandary, Ravi S Tripathi, Nicholas C Joseph, John D Hummel, Ralph S Augostini, Steven J Kalbfleisch, Jaret D Tyler, Mahmoud Houmsse, Emile G Daoud
BACKGROUND: The recently approved subcutaneous implantable cardioverter/defibrillator (S-ICD) uses a single extrathoracic subcutaneous lead to treat life-threatening ventricular arrhythmias, such as ventricular tachycardia and ventricular fibrillation. This is different from conventional transvenous ICDs, which are typically implanted under sedation. Currently, there are no reports regarding the anesthetic management of patients undergoing S-ICD implantation. STUDY OBJECTIVES: This study describes the anesthetic management and outcomes in patients undergoing S-ICD implantation and defibrillation threshold (DFT) testing...
June 2016: Journal of Clinical Anesthesia
Hideo Okamura, Christopher J McLeod, Christopher V DeSimone, Tracy L Webster, Crystal R Bonnichsen, Martha Grogan, Sabrina D Phillips, Heidi M Connolly, Naser M Ammash, Carole A Warnes, Paul A Friedman
BACKGROUND: The subcutaneous implantable cardioverter defibrillator (S-ICD) provides an attractive option for patients with congenital heart disease (CHD) in whom a transvenous defibrillator is contraindicated. Given the unusual cardiac anatomy and repolarization strain, the surface electrocardiogram (ECG) is frequently abnormal, potentially increasing the screen failure rate. METHODS AND RESULTS: We prospectively screened 100 adult CHD patients regardless of the presence of clinical indication for ICD utilizing a standard left sternal lead placement, as well as a right parasternal position...
May 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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