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https://www.readbyqxmd.com/read/28432805/pitfalls-in-electrogram-interpretation-subcutaneous-cardioverter-defibrillator-malfunction-in-brugada-syndrome
#1
Giovanni Morani, Bruna Bolzan, Luca Tomasi, Ruggero Tomei, Corrado Vassanelli
A patient with Brugada Syndrome implanted with subcutaneous cardioverter defibrillator (S-ICD) had oversensing episodes treated with S-ICD shocks. Comparable artefacts weren't evocable with S-ICD pocket manipulation. The fluoroscopy excluded S-ICD macroscopic damage. The device extraction revealed undamaged pulse generator and connector, but the lead was inappropriately tunnelled under the sixth rib. Then the S-ICD malfunction was due to lead microscopic damage caused by lead rubbing the rib surface. This article is protected by copyright...
April 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28416987/importance-of-exercise-testing-shortly-after-subcutaneous-implantable-cardioverter-defibrillator-implantation-in-patients-with-brugada-syndrome-the-first-case-of-associated-inappropriate-shock-in-japan
#2
Kohei Ishibashi, Takashi Noda, Tsukasa Kamakura, Mitsuru Wada, Yuko Inoue, Hideo Okamura, Kengo Kusano
We report the case of a 51-year-old patient with Brugada syndrome (BrS) who experienced inappropriate shock due to T-wave oversensing (TWOS) during exercise when the optimal sensing vector was selected based on the automatic analysis by a subcutaneous implantable cardioverter-defibrillator (S-ICD). After selecting another vector during exercise testing, TWOS did not re-occur. Selection of appropriate sensing vector based on analyses under various conditions, including during exercise after S-ICD implantation, should be considered for patients with BrS...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28408651/disease-severity-and-exercise-testing-reduce-subcutaneous-implantable-cardioverter-defibrillator-left-sternal-ecg-screening-success-in-hypertrophic-cardiomyopathy
#3
Neil T Srinivasan, Kiran H Patel, Kashif Qamar, Amy Taylor, Marco Bacà, Rui Providência, Maria Tome-Esteban, Perry M Elliott, Pier D Lambiase
BACKGROUND: The features of the hypertrophic cardiomyopathy (HCM) ECG make it a challenge for subcutaneous implantable cardioverter-defibrillator (S-ICD) screening. We aimed to investigate the causes of screening failure at rest and on exercise to inform optimal S-ICD ECG vector development. METHODS AND RESULTS: One hundred and thirty-one HCM patients (age, 50±16 years; 92 males and 39 females) with ≥1 HCM risk factor for sudden death underwent S-ICD ECG screening at rest and on exercise...
April 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28383717/characteristics-and-early-clinical-outcomes-of-patients-undergoing-totally-subcutaneous-vs-transvenous-single-chamber-implantable-cardioverter-defibrillator-placement
#4
Ali A Mithani, Heaton Kath, Krystal Hunter, John Andriulli, Matthew Ortman, Julie Field, Andrea M Russo
Aims: In 2012, the first totally Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) was approved by the Food and Drug Administration (FDA) in the United States. A possible benefit of this device is that it does not involve placing leads 'in' or 'on' the heart, potentially reducing complications. Methods amd results: Ninety-one S-ICD and 182 single chamber TV-ICD implants were performed between 10/22/2012 and 9/22/2015. During this period of time, 91 patients with S-ICD were matched to TV-ICD patients using single centre NCDR ICD Registry Data based on dialysis status, gender, and age...
April 4, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28377992/electrode-positions-transformation-coordinates-for-ecg-reconstruction-from-s-icd-vectors
#5
David G Wilson, Peter L Cronbach, D Panfilo, Saul E Greenhut, Berthold P Stegemann, John M Morgan
The article contains data pertaining to the reconstruction of an 8-lead ECG from 2 subcutaneous implantable cardioverter defibrillator vectors. The location of electrodes on the precordium required for the data collection are detailed; the flow chart for patient selection and exclusion is shown; the summary data of the root mean square error (RMSE) (in microvolts) and Pearson r for the ECG transformation all cases and the pearson correlation for all the leads measured and reconstructed leads are also shown...
April 2017: Data in Brief
https://www.readbyqxmd.com/read/28377192/sudden-cardiac-death-new-approaches-for-implantable-cardioverter-defibrillators-icds
#6
Riccardo Cappato, Hussam Ali
The implantable cardioverter-defibrillator (ICD) has shown its superiority to anti-arrhythmic drugs in the prevention of sudden cardiac death. However, the conventional transvenous ICDs are still associated with substantial risks and comorbidities mainly related to the transvenous leads. The recent advent of an entirely sub-cutaneous ICD (S-ICD) represents an important progress in the defibrillation technology towards a less invasive approach. Clinical data are growing regarding the safety and efficacy of S-ICD in prevention of sudden cardiac death in selected patients without pacing indications...
March 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28367844/surface-electrocardiogram-screening-for-subcutaneous-implantable-cardioverter-defibrillators-in-japanese-patients-with-and-without-brugada-syndrome
#7
Mihoko Kawabata, Masahiko Goya, Takeshi Sasaki, Shingo Maeda, Atsuhiko Yagishita, Yasuhiro Shirai, Masakazu Kaneko, Shinya Shiohira, Mitsuaki Isobe, Kenzo Hirao
BACKGROUND: Subcutaneous implantable cardioverter-defibrillators (S-ICD) could eliminate lead-associated complications. We assessed the prevalence of S-ICD ineligibility in conventional ICD recipients and compared it in patients with and without Brugada syndrome (BrS).Methods and Results:Consecutive patients with a transvenous ICD without an indication for antibradycardia pacing were assessed. A patient was considered eligible for S-ICD if the ECG satisfied the screening template, both supine and standing, in ≥1 lead...
March 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28340026/high-rate-of-subcutaneous-implantable-cardioverter-defibrillator-sensing-screening-failure-in-patients-with-brugada-syndrome-a-comparison-with-other-inherited-primary-arrhythmia-syndromes
#8
Giulio Conte, Mihoko Kawabata, Carlo de Asmundis, Erika Taravelli, Francesco Petracca, Diego Ruggiero, Maria Luce Caputo, François Regoli, Gian-Battista Chierchia, Alessandra Chiodini, Alessandro Del Bufalo, Tiziano Moccetti, Masahiko Goya, Kenzo Hirao, Alessandro Vicentini, Gaetano M De Ferrari, Pedro Brugada, Angelo Auricchio
Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) can avoid important complications associated with transvenous leads in patients with inherited primary arrhythmia syndromes, who do not need pacing therapy. Few data are available on the percentage of patients with inherited arrhythmia syndromes eligible for S-ICD implantation. Aim of this study was to analyse the eligibility for S-ICD in a series of patients with Brugada syndrome (BrS), and to compare it with patients with other channelopathies...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340005/inappropriate-shocks-in-single-chamber-and-subcutaneous-implantable-cardioverter-defibrillators-a-systematic-review-and-meta-analysis
#9
Angelo Auricchio, J Harrison Hudnall, Edward J Schloss, Laurence D Sterns, Takashi Kurita, Albert Meijer, Dedra H Fagan, Tyson Rogers
Aims: Single-chamber (VR-ICD) and subcutaneous (S-ICD) implantable cardioverter-defibrillators are effective to protect patients against sudden death but expose them to higher risk of inappropriate shock (IS). We sought to quantify the annual rate and influencing factors of ISs in VR- and S-ICDs from the literature. Methods and results: PubMed, Embase, and Cochrane Library were searched for full text articles with IS rates. Poisson distribution estimated proportion of patients with ISs; rates were annualized based on follow-up duration...
March 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28217234/inappropriate-shocks-from-a-subcutaneous-implantable-cardioverter-defibrillator-due-to-oversensing-during-periods-of-rate-related-bundle-branch-block
#10
Maria João Sousa, Tim Betts
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel technology with proven efficacy in sudden cardiac death prevention; however, there is a lack of long-term safety data. We describe the case of a 55-year-old female patient implanted with an S-ICD due to idiopathic ventricular fibrillation, who subsequently presented with inappropriate shocks leading to ventricular fibrillation that was successfully terminated by another shock. Inappropriate shocks were due to intermittent T wave oversensing during periods of rate-dependent right bundle branch block...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28185354/eligibility-of-pacemaker-patients-for-subcutaneous-implantable-cardioverter-defibrillators
#11
James E Ip, Michael S Wu, Peter J Kennel, George Thomas, Christopher F Liu, Jim W Cheung, Steven M Markowitz, Bruce B Lerman
INTRODUCTION: The subcutaneous implantable cardioverter defibrillator (ICD) has emerged as a viable therapeutic option for patients who are deemed high risk for sudden cardiac death. Previous studies have shown that 7-15% of patients are not candidates for the S-ICD based on their intrinsic QRS/T-wave morphology. Presently, it is not known if the S-ICD can be considered as supplementary therapy in patients who are ventricularly paced. We sought to determine the proportion of ventricularly paced patients who would qualify for an S-ICD...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28185283/discrimination-between-qrs-and-t-waves-using-a-right-parasternal-lead-for-s-icd-in-a-patient-with-a-single-ventricle
#12
Takahiko Nishiyama, Takehiro Kimura, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a useful option for patients with a single ventricle (SV) in which transvenous leads are contraindicated because of intracardiac shunts. We report a case in which a right parasternal lead placement was indicated for an S-ICD in a resuscitated patient with an SV. There were significant changes in the magnitude of R to T waves ratio in the right compared to left parasternal lead position. Screening in the right parasternal position is effective for selecting appropriate patients with CHD for S-ICD implantations...
February 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28185079/-a%C3%A2-life-saving-shock-from-a%C3%A2-subcutaneous-icd-during-skydiving
#13
Stefan Baumann, Susanne Roeger, Tobias Becher, Ibrahim Akin, Martin Borggrefe, Juergen Kuschyk
We report the case of a 38-year-old man who was implanted a subcutaneous implantable cardioverter-defibrillator (S-ICD) and then performed a skydive from a height of 3000 m. During the jump, he lost consciousness due to ventricular fibrillation (VF). The S‑ICD detected the VF properly and successfully shocked the arrhythmia. Our illustrative case emphasizes the S‑ICD as an appropriate therapy in patient with life-threatening arrhythmias even under extreme conditions.
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28163146/the-subcutaneous-icd-as-an-alternative-to-the-conventional-icd-system-initial-experience-in-greece-and-review-of-the-literature
#14
REVIEW
Skevos Sideris, Stefanos Archontakis, Konstantinos A Gatzoulis, Aristotelis Anastasakis, Ilias Sotiropoulos, Petros Arsenos, Alexandros Kasiakogias, Dimitrios Terentes, Konstantinos Trachanas, Eleftherios Paschalidis, Dimitrios Tousoulis, Ioannis Kallikazaros
The introduction of the implantable cardioverter defibrillator (ICD) in clinical practice has revolutionized our therapeutic approach for sudden cardiac death (SCD) both in the context of primary and secondary prevention, since it has proven to be superior to medical therapy in treating potentially life-threatening ventricular arrhythmias, resulting in reduced mortality rates. However, conventional ICDs' implantation carries a not negligible risk of periprocedural and long-term complications associated with the transvenous ICD leads...
February 2, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28159357/reconstruction-of-an-8-lead-surface-ecg-from-two-subcutaneous-icd-vectors
#15
David G Wilson, Peter L Cronbach, D Panfilo, Saul E Greenhut, Berthold P Stegemann, John M Morgan
INTRODUCTION: Techniques exist which allow surface ECGs to be reconstructed from reduced lead sets. We aimed to reconstruct an 8-lead ECG from two independent S-ICD sensing electrodes vectors as proof of this principle. METHODS: Participants with ICDs (N=61) underwent 3minute ECGs using a TMSi Porti7 multi-channel signal recorder (TMS international, The Netherlands) with electrodes in the standard S-ICD and 12-lead positions. Participants were randomised to either a training (N=31) or validation (N=30) group...
January 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28073660/effectiveness-of-subcutaneous-implantable-cardioverter-defibrillator-testing-in-patients-with-hypertrophic-cardiomyopathy
#16
Niccoló Maurizi, Ilaria Tanini, Iacopo Olivotto, Ernesto Amendola, Giuseppe Limongelli, Maria Angela Losi, Giuseppe Allocca, Giovanni Battista Perego, Paolo Pieragnoli, Giuseppe Ricciardi, Paolo De Filippo, Paola Ferrari, Giovanni Quarta, Stefano Viani, Antonio Rapacciuolo, Maria Grazia Bongiorni, Franco Cecchi
BACKGROUND: Subcutaneous ICD (S-ICD) is a promising option for Hypertrophic Cardiomyopathy (HCM) patients at risk of Sudden Cardiac Death (SCD). However, its effectiveness in terminating ventricular arrhythmias in HCM is yet unresolved. METHODS: Consecutive HCM patients referred for S-ICD implantation were prospectively enrolled. Patients underwent one or two attempts of VF induction by the programmer. Successful conversion was defined as any 65J shock that terminated VF (not requiring rescue shocks)...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28070890/the-role-of-conventional-and-right-sided-ecg-screening-for-subcutaneous-icd-in-a-tetralogy-of-fallot-population
#17
RANDOMIZED CONTROLLED TRIAL
Pau Alonso, Joaquín Osca, Oscar Cano, Pedro Pimenta, Ana Andrés, Jaime Yagüe, José Millet, Joaquín Rueda, María José Sancho-Tello
BACKGROUND: Information regarding suitability for subcutaneous implantable cardioverter-defibrillator (S-ICD) implant in tetralogy of Fallot (ToF) population is scarce and needs to be further explored. THE AIMS OF OUR STUDY WERE: (1) to determine the proportion of patients with ToF eligible for S-ICD, (2) to identify the optimal sensing vector in ToF patients, (3) to test specifically the eligibility for S-ICD with right-sided screening, and (4) to compare with the proportion of eligible patients in a nonselected ICD population...
February 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28034575/complete-right-bundle-branch-block-and-qrs-t-discordance-can-be-the-initial-clue-to-detect-s-icd-ineligibility
#18
Motomi Tachibana, Nobuhiro Nishii, Yoshimasa Morimoto, Satoshi Kawada, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito
BACKGROUND: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG). METHODS: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously...
December 26, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28011803/the-italian-subcutaneous-implantable-cardioverter-defibrillator-survey-s-icd-why-not
#19
Giovanni Luca Botto, Giovanni B Forleo, Alessandro Capucci, Francesco Solimene, Antonello Vado, Giovanni Bertero, Pietro Palmisano, Ennio Pisanò, Antonio Rapacciuolo, Tommaso Infusino, Alessandro Vicentini, Miguel Viscusi, Paola Ferrari, Antonello Talarico, Giovanni Russo, Giuseppe Boriani, Luigi Padeletti, Mariolina Lovecchio, Sergio Valsecchi, Antonio D'Onofrio
AIMS: A recommendation for a subcutaneous-implantable cardioverter-defibrillator (S-ICD) has been added to recent European Society of Cardiology Guidelines. However, the S-ICD is not ideally suitable for patients who need pacing. The aim of this survey was to analyse the current practice of ICD implantation and to evaluate the actual suitability of S-ICD. METHODS AND RESULTS: The survey 'S-ICD Why Not?' was an independent initiative taken by the Italian Heart Rhythm Society (AIAC)...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28007749/intermuscular-technique-for-implantation-of-the-subcutaneous-implantable-cardioverter-defibrillator-long-term-performance-and-complications
#20
Joachim Winter, Markus Siekiera, Dong-In Shin, Christian Meyer, Patric Kröpil, Harald Clahsen, Stephen O'Connor
AIMS: The subcutaneous cardioverter defibrillator was designed to overcome electrode complications of transvenous defibrillation systems. While largely achieved, pocket complications have increased. Subcutaneous implantation of the pulse generator leaves it prone to erosion, extrusion, discomfort, and poor cosmesis. METHODS AND RESULTS: We use a demonstration electrode and pulse generator with fluoroscopy, prior to prepping and draping, to maximize the left ventricular mass between them...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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