A 10 J shock impedance in sinus rhythm correlates with a 65 J defibrillation impedance during subcutaneous defibrillator implantation using an intermuscular technique

Okabe, Toshimasa; Savona, Salvatore; Matto, Faisal; Ward, Chad; Singh, Prabhpreet; Afzal, Muhammad R.; Kalbfleisch, Steven J.; Weiss, Raul; Houmsse, Mahmoud; Augostini, Ralph; Hummel, John D.; Daoud, Emile G.

doi:10.1111/jce.15249

Cited by 6 publications

(1 citation statement)

References 23 publications

(27 reference statements)

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“…In patients with contraindications for a DFT, a 10 J test shock with no VF induction is considered a surrogate of DFT, as it allows for true high-voltage impedance measurement (and not its low-voltage approximation). That method cannot confirm appropriate VF sensing and detection, and the value of impedance measurement only is disputable [ 99 , 100 ], as it may vary with the patient’s body composition and built, chest fluid content (e.g., pleural effusion) and device location. There are several reports available suggesting that DFT testing may be safely waived in S-ICD patients [ 101 , 102 ], but more conclusive data are awaited from the PRAETORIAN-DFT trial, which was designed to investigate the possibility of substituting the DFT with PRAETORIAN score calculation only [ 103 ].…”

Section: Defibrillation Testingmentioning

confidence: 99%

S-ICD Implantation "Tips and Tricks"

Budrejko¹,

Kempa²,

Przybylski³

2023

Rev. Cardiovasc. Med.

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An implantable cardioverter-defibrillator (ICD) was developed to provide protection against sudden cardiac death. Despite being effective in terminating ventricular arrhythmias, traditional transvenous ICDs appeared over time to have certain limitations related to the need for vascular access and the presence of foreign material inside the circulatory system (namely lead failure and infections). A subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to overcome those limitations and to provide prevention against sudden cardiac death from outside the cardiovascular system. Utilization of that modern method of treatment is constantly increasing worldwide, and new centers incorporate implantation of that system in their portfolio. This review aims to present the most relevant issues related to S-ICD implantation procedure, based on experience of the authors and an extensive literature search.

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Section: Defibrillation Testingmentioning

confidence: 99%

S-ICD Implantation "Tips and Tricks"

Budrejko¹,

Kempa²,

Przybylski³

2023

Rev. Cardiovasc. Med.

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Innovations in atrial fibrillation ablation

Kim

Khan

Kherallah

et al. 2022

J Interv Card Electrophysiol

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Intermuscular two-incision technique for implantation of the subcutaneous implantable cardioverter defibrillator: a 3-year follow-up

Migliore

Pittorru

Giacomin

et al. 2023

J Interv Card Electrophysiol

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Purpose The aim of the present study was to evaluate the outcome of patients underwent subcutaneous implantable cardioverter defibrillator (S-ICD) implantation with the intermuscular (IM) two-incision technique during 3-year follow-up. Methods the study population consisted of 105 consecutive patients (79 male; median 50 [13–77] years) underwent S-ICD implantation with the IM two-incision technique. The composite primary end point of the study consisted of device-related complications and inappropriate shocks (IAS). Secondary end points included the individual components of the primary end point, death from any cause, appropriate therapy, major adverse cardiac events, hospitalization for heart failure, and heart transplantation. Results According to the PRAETORIAN score, the risk of conversion failure was classified as low in 99 patients (94.3%), intermediate in 6 (5.7%).Ventricular fibrillation was successfully converted at ≤65 J in 97.4% of patients. During a median follow-up of 39 (16–53) months, 10 patients (9.5%) experienced device-related complications, and 9 (8.5%) patients reported IAS. Lead-associated complications were the most common (5 patients, 4.7%), including 2 cases of lead failure (1.9%). Pocket complications were reported in 2 patients (1.9%). Extra-cardiac oversensing (3.8%) represented the leading cause of IAS. No T-wave oversensing episodes were recorded. Twelve patients (11.4%) experienced appropriate shocks. Eight patients (7.6%) died during follow-up. IAS or device-related complications did not impact on mortality. Conclusions The overall device-related complications and IAS rates over 3 years of follow-up were 9.5% and 8.5%, respectively. According to our findings, the IM two-incision technique allows for optimal positioning of the device achieving a low PRAETORIAN score with a high conversion rate. IM two-incision technique allows low incidence of pocket complications, shifting the type of complications towards lead-related complications, which represent the most common complications. The IM two-incision technique would not seem to impact the occurrence of IAS. Management of complications are safe without impact on the outcome.

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A 10 J shock impedance in sinus rhythm correlates with a 65 J defibrillation impedance during subcutaneous defibrillator implantation using an intermuscular technique

Cited by 6 publications

References 23 publications

S-ICD Implantation "Tips and Tricks"

S-ICD Implantation "Tips and Tricks"

Innovations in atrial fibrillation ablation

Intermuscular two-incision technique for implantation of the subcutaneous implantable cardioverter defibrillator: a 3-year follow-up

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