Eligibility for subcutaneous implantable cardioverter-defibrillator in patients with left ventricular assist device

Zormpas, Christos; Eiringhaus, Jörg; Hillmann, Henrike Aenne Katrin; Hohmann, Stephan; Müller-Leisse, Johanna; Schmitto, Jan D.; Veltmann, Christian; Duncker, David

doi:10.1007/s10840-020-00810-1

Cited by 8 publications

(19 citation statements)

References 32 publications

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“…With the ECG-based screening test higher eligibility rates (66.6%), similar to those found in the present study, were observed. 7 Thus, S-ICD eligibility in patients with LVAD is lower in comparison to patients with heart failure without an LVAD. 17,18 In the present study, 66 patients (57%) were found eligible for…”

Section: Discussionmentioning

confidence: 99%

“…Conventional limb electrodes (LA, RA, LL) were placed according to manufacturer recommendations as described elsewhere (Figure 2B). 7 These simulated S‐ICD vectors were obtained at gains of 5, 10, and 20 mV/cm at a paper speed of 25 mm/s using an ECG device (MAC 5500; GE Healthcare) in supine and erect position. S‐ICD eligibility was evaluated in both left and right parasternal position.…”

Section: Methodsmentioning

confidence: 99%

“…Conventional limb electrodes (LA, RA, LL) were placed according to manufacturer recommendations as described elsewhere ( Figure 2B). 7 These simu-…”

Section: Standard Ecg-based Screening Testmentioning

confidence: 99%

“…4 A recent study showed S-ICD eligibility rates of 73.3% in patients with LVAD. 7 An S-ICD screening test is recommended before S-ICD implantation to evaluate appropriate sensing though not predicting S-ICD efficacy. S-ICD eligibility is examined using a screening test based on the surface electrocardiogram (ECG), namely the manual ECG-based and/or the automated screening test performed using the manufacturer's programmer.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study showed S‐ICD eligibility rates of 73.3% in patients with LVAD 7 . An S‐ICD screening test is recommended before S‐ICD implantation to evaluate appropriate sensing though not predicting S‐ICD efficacy.…”

Section: Introductionmentioning

confidence: 99%

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A novel screening tool to unmask potential interference between S‐ICD and left ventricular assist device

Zormpas

Eiringhaus

Hillmann

et al. 2020

Cardiovasc electrophysiol

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Introduction: In patients with a left ventricular assist device (LVAD), the subcutaneous implantable cardioverter-defibrillator (S-ICD) can be an alternative to transvenous ICD systems due to reduced risk of systemic infection, which could lead to extraction of the ICD as well as the LVAD. S-ICD eligibility is lower in patients with LVAD than in patients with end-stage heart failure without LVAD. Several reports have shown inappropriate S-ICD therapy in the coexistence of LVAD and S-ICD. The aim of the present study was to evaluate S-ICD eligibility in patients with LVAD using the established electrocardiogram (ECG)-based screening test as well as a novel device-based screening test to identify potentially inappropriate S-ICD sensing in this specific patient cohort. Methods and Results: The present study included 115 patients implanted with an LVAD. The standard ECG-based screening test and a novel device-based screening test were performed in all patients. Eighty patients (70%) were eligible for S-ICD therapy with the standard ECG-based screening test. Performance of the novel device-based screening test identified device-device interference in 14 of these 80 patients (12%). Conclusion: Using a novel extended device-based S-ICD screening method, a small number of patients with LVAD deemed eligible for S-ICD with the standard ECG-based screening test exhibit device-device interference. Careful S-ICD screening should be performed in patients with LVAD, who are candidates for S-ICD therapy, to prevent inappropriate sensing or ICD therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Conventional limb electrodes (LA, RA, LL) were placed according to manufacturer recommendations as described elsewhere ( Figure 2B). 7 These simu-…”

Section: Standard Ecg-based Screening Testmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A novel screening tool to unmask potential interference between S‐ICD and left ventricular assist device

Zormpas

Eiringhaus

Hillmann

et al. 2020

Cardiovasc electrophysiol

Self Cite

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show abstract

Wireless Power Transfer and Telemetry for Implantable Bioelectronics

Yoo

Lee

Joo

et al. 2021

Adv Healthcare Materials

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Implantable bioelectronic devices are becoming useful and prospective solutions for various diseases owing to their ability to monitor or manipulate body functions. However, conventional implantable devices (e.g., pacemaker and neurostimulator) are still bulky and rigid, which is mostly due to the energy storage component. In addition to mechanical mismatch between the bulky and rigid implantable device and the soft human tissue, another significant drawback is that the entire device should be surgically replaced once the initially stored energy is exhausted. Besides, retrieving physiological information across a closed epidermis is a tricky procedure. However, wireless interfaces for power and data transfer utilizing radio frequency (RF) microwave offer a promising solution for resolving such issues. While the RF interfacing devices for power and data transfer are extensively investigated and developed using conventional electronics, their application to implantable bioelectronics is still a challenge owing to the constraints and requirements of in vivo environments, such as mechanical softness, small module size, tissue attenuation, and biocompatibility. This work elucidates the recent advances in RF‐based power transfer and telemetry for implantable bioelectronics to tackle such challenges.

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Eligibility for subcutaneous implantable cardioverter‐defibrillator in adults with congenital heart disease

et al. 2021

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Aims Patients with adult congenital heart disease (ACHD) carry an increased risk for sudden cardiac death. Implantable cardioverter-defibrillator (ICD) therapy may be challenging in these patients due to anatomical barriers, repeated cardiac surgery, or complicated transvenous access. Thus, the subcutaneous ICD (S-ICD) can be a promising alternative in this patient population. Patients with ACHD show significant electrocardiogram (ECG) abnormalities, which could affect S-ICD sensing because it depends on surface ECG. Methods and results One hundred patients with ACHD were screened for S-ICD eligibility. Standard ECG-based screening test and automated S-ICD screening test were performed in all patients. Sixty-six patients (66%) were male. Underlying congenital heart disease (CHD) was mainly CHD of great complexity (71%) and moderate complexity (29%), including repaired tetralogy of Fallot (20%), which was the most common entity. Thirty-seven patients (37%) already had a pacemaker (23%) or ICD (14%) implanted. Automated screening test identified 83 patients (83%) eligible for S-ICD implantation in either left parasternal position (78%) or right parasternal position (75%). Absence of sinus rhythm, QRS duration, and a paced QRS complex were associated with S-ICD screening failure in univariate analysis. Receiver operating characteristic curve and multivariate analysis revealed a QRS duration ≥148 ms as the only independent predictor for S-ICD screening failure. Conclusions Patients with ACHD show satisfactory eligibility rates (83%) for S-ICD implantation utilizing the automated screening test, including patients with CHD of high complexity. S-ICD therapy should be considered with caution in ACHD patients with a QRS duration ≥148 ms and/or need for ventricular pacing.

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Eligibility for subcutaneous implantable cardioverter-defibrillator in patients with left ventricular assist device

Cited by 8 publications

References 32 publications

A novel screening tool to unmask potential interference between S‐ICD and left ventricular assist device

A novel screening tool to unmask potential interference between S‐ICD and left ventricular assist device

Wireless Power Transfer and Telemetry for Implantable Bioelectronics

Eligibility for subcutaneous implantable cardioverter‐defibrillator in adults with congenital heart disease

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