Conventional and alternative preimplantation ECG screening for subcutaneous ICD in high risk hypertrophic cardiomyopathy patients

Kaczmarek, Krzysztof; Kałowski, Michał; Wranicz, Jerzy Krzysztof; Ptaszyńsk, Pawel; Cygankiewicz, Iwona

doi:10.1016/j.jelectrocard.2019.11.044

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…102 Screening for S-implantable cardioverter-defibrillator fails in 14 to 38% of hypertrophic cardiomyopathy patients due to higher risk of T-wave sensing which may improve by alternative placement of the screening electrodes. 103 S-implantable cardioverter-defibrillator therapy in hypertrophic cardiomyopathy patients appears effective in the recognition and termination of ventricular tachycardia/ventricular fibrillation even in the presence of extreme left ventricular hypertrophy. 104,105 Cardiac pacing and thereby antitachycardia pacing is impossible in S-implantable cardioverter-defibrillator which can be a disadvantage for hypertrophic cardiomyopathy patients with monomorphic ventricular tachycardia as presenting rhythm.…”

Section: Device and Lead Systemsmentioning

confidence: 99%

Indications and management of implantable cardioverter-defibrillator therapy in childhood hypertrophic cardiomyopathy

et al. 2023

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Sudden cardiac death is the most common mode of death during childhood and adolescence in hypertrophic cardiomyopathy, and identifying those individuals at highest risk is a major aspect of clinical care. The mainstay of preventative therapy is the implantable cardioverter-defibrillator, which has been shown to be effective at terminating malignant ventricular arrhythmias in children with hypertrophic cardiomyopathy but can be associated with substantial morbidity. Accurate identification of those children at highest risk who would benefit most from implantable cardioverter-defibrillator implantation while minimising the risk of complications is, therefore, essential. This position statement, on behalf of the Association for European Paediatric and Congenital Cardiology (AEPC), reviews the currently available data on established and proposed risk factors for sudden cardiac death in childhood-onset hypertrophic cardiomyopathy and current approaches for risk stratification in this population. It also provides guidance on identification of individuals at risk of sudden cardiac death and optimal management of implantable cardioverter-defibrillators in children and adolescents with hypertrophic cardiomyopathy.

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Section: Device and Lead Systemsmentioning

confidence: 99%

Indications and management of implantable cardioverter-defibrillator therapy in childhood hypertrophic cardiomyopathy

et al. 2023

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“…We encountered preoperatively difficulties in obtaining proper sensing vectors in patients with HCMP, probably due to oversensed high-voltage T, wide and fragmented QRS. The solution was the right parasternal lead position and dorsal device position behind the mid-axillary line [15]. Another point is a large device size: Emblem™ A219: volume 59.5 ml, and size 83.1 × 69.1 × 12.7 mm.…”

Section: Resultsmentioning

confidence: 99%

Subcutaneous implantable cardioverter-defibrillator and the two-incision intermuscular technique in pediatric patients — a single center experience

et al. 2021

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“…The ECG screening was repeated for the S-ICD pulse generator placed more dorsally and the lead in RPP and one vector was deemed acceptable [50] . Based on that case, the same study group described that the alternative placement of screening surface electrodes (precordial electrodes shifted to rightwards and lateral electrode dorsally) could be a valuable method to increase eligibility for the S-ICD in these patients, consequently implanting the S-ICD system according to the alternative screening landmarks [51] .…”

Section: Discussionmentioning

confidence: 99%

Subcutaneos Implantable Cardioverter: Defibrillator: Is the Conventional Pre-Implant Screening Enough to Assess Eligibility?

Brito

Martinez²,

Cladera³

et al. 2023

ijirms

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Aims: The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires screening prior to implantation. Surface anatomical landmarks (SAL) guide the screening. The heart silhouette shows variations, therefore, these landmarks may differ. We aimed to determine the concordance between SAL and fluoroscopy guided screening, and analyze discordance predicting factors. Methods: We performed a conventional SAL guided screening (CS) in left and right parasternal electrode position (LPP/RPP) to candidates for S-ICD. Subsequently, we performed a fluoroscopy guided screening (FGS) according to cardiac silhouette. Screenings in which at least the result of one sensing vector did not coincide were considered “discordant”. A comparison was done between discordant vs. concordant cases. A simple binary logistic regression analysis was performed to assess the risk of being discordant individually for each of the variables. Results: The results of CS and FGS were compared in 110 patients (220 comparisons: 110 LPP and 110 RPP). 90 (40.91%) were discordant in at least one sensing vector (46 in LPP and 44 in RPP). In 3 patients (2.73%) the indication of which type of defibrillator was implanted changed according to the FGS. There were no significant differences between the discordant and concordant screening patients. Conclusion: There is a level of discordance between CS and FGS. There were no analyzed factors that were able to predict discordance between these two screening methods. It might be reasonable to perform FGS before implant.

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Conventional and alternative preimplantation ECG screening for subcutaneous ICD in high risk hypertrophic cardiomyopathy patients

Cited by 6 publications

References 18 publications

Indications and management of implantable cardioverter-defibrillator therapy in childhood hypertrophic cardiomyopathy

Indications and management of implantable cardioverter-defibrillator therapy in childhood hypertrophic cardiomyopathy

Subcutaneous implantable cardioverter-defibrillator and the two-incision intermuscular technique in pediatric patients — a single center experience

Subcutaneos Implantable Cardioverter: Defibrillator: Is the Conventional Pre-Implant Screening Enough to Assess Eligibility?

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