Novel Minimally Invasive, Intrapericardial Implantable Cardioverter Defibrillator Coil System: A Useful Approach to Arrhythmia Therapy in Children

Hsia, Tain Yen; Bradley, Scott M.; LaPage, Martin J.; Whelan, S.D.; Saul, J. Philip; Ringewald, Jeremy M.; Reed, John H.

doi:10.1016/j.athoracsur.2009.01.015

Cited by 54 publications

(35 citation statements)

References 26 publications

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“…These devices, including pacemakers, 1 cardiac defibrillators, 2 nerve stimulators, 3 and drug delivery systems, 4 are utilized to manage a broad range of ailments such as diabetes, 5 arrhythmia, 6 and Parkinson disease. 7 Together, they comprise investments of billions of dollars annually.…”

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confidence: 99%

Gold nanoparticle-doped biocompatible silk films as a path to implantable thermo-electrically wireless powering devices

Tao

Siebert

Brenckle

et al. 2010

Applied Physics Letters

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In this paper, we report on gold nanoparticle (GNP) doped silk films as an implantable and degradable heating element activated by light, which can be potentially used for wireless powering of implanted microdevices. Proof-of-concept experiments have been conducted by casting a GNP doped silk film on a miniature thermal-power chip, which generates ∼20 mW when illuminated by a green laser with an output power of 450 mW/mm2 at 532 nm.

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confidence: 99%

Gold nanoparticle-doped biocompatible silk films as a path to implantable thermo-electrically wireless powering devices

Tao

Siebert

Brenckle

et al. 2010

Applied Physics Letters

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“…Leads have been placed in pediatric patients by percutaneous subxiphoid pericardial access or via a small surgical subxiphoid incision to access the pericardial space. 10,11 In the adult population, surgical access requires more extensive dissection. However, percutaneous pericardial access is now commonly used for epicardial ablation of arrhythmias and can be safely achieved in patients without previous cardiac surgery or pericardial disease.…”

Section: Discussionmentioning

confidence: 99%

Acute and Chronic Performance Evaluation of a Novel Epicardial Pacing Lead Placed by Percutaneous Subxiphoid Approach in a Canine Model

John

Morgan

Brennecke

et al. 2015

Circ: Arrhythmia and Electrophysiology

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The basic design for the intrapericardial leads (IPLs) used a diamond-shaped loop for stability at the distal end and a preshaped lead body within the diamond loop in which the bipolar, nonsteroid eluting, electrodes were located (Figure 1). The electrodes were titanium nitride-coated platinum iridium, 5 mm 2 in dimension © 2015 American Heart Association, Inc. Original ArticleBackground-Endovascularly implanted leads risk vascular injury and endocarditis, and can be difficult to locate in desired positions for LV pacing. We evaluated the acute and long-term stability, electric performance and histopathology of a percutaneously placed intrapericardial lead (IPL). Methods and Results-Twelve adult mongrel dogs underwent defibrillator implants incorporating IPLs. Successful uncomplicated percutaneous implantation of an IPL was achieved in all. Early fluoroscopic shift noted with 3 of 6 of the initial version IPL-1 was not seen with the modified IPL-2. Mean±95% confidence interval bipolar capture threshold at 0.5-ms pulse width for the IPL increased from 0.69±0.14 V at implant to 1.50±0.34 V (P=0.003) at 12 weeks. The 12-week thresholds were higher for IPL compared with right ventricular endocardial leads (0.75±0.33 V; P=0.001) but not different compared with coronary sinus leads (1.33±0.58 V; P=0.994). IPL impedance increased from 742±46 Ω at implant to 1066±207 Ω at 12 weeks (P=0.007). R-wave amplitude at 12 weeks was 8.37±1.52 mV. There was no important phrenic nerve stimulation from IPL pacing. Histopathology in 8 animals showed adequate adhesion of the electrodes or mesh to the epicardium without damage to underlying vasculature. There was no evidence for late pericardial inflammation or effusion. Conclusions-The IPL demonstrated adequate stability of position and acceptable electric parameters without chronic pericardial inflammation in this canine model and offers a potential alternative to endocardial pacing leads.

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“…However, intrapericardial implantation may lead to pericarditis, life-threatening pericardial tamponade, and adhesions and may induce ventricular arrhythmias by irritating the myocardium. Implantation into a previously opened pericardium in operated congenital heart diseases is another limitation of intrapericardial implantation (16, 17). …”

Section: Discussionmentioning

confidence: 99%

Subcutaneous defibrillator implantation in pediatric patients

et al. 2015

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Objective:Although sudden cardiac death is rare in children, an intracardiac defibrillator system is indicated in children with various types of cardiomyopathy, primary electrical diseases, and after surgical repair of congenital heart defects. The use of transvenous defibrillator lead systems is limited in pediatric patients because of a small body size and/or limited vascular access. Subcutaneous array leads combined with an abdominally placed generator can enable implantation.Method:This is a retrospective study of 13 patients who underwent subcutaneous defibrillator implantation between September 2010 and March 2015. The subcutaneous system was preferred because patients were not amenable to transvenous lead placement.Results:The median patient age was 4.1 years, and the median patient weight was 12.1 kg. Diagnoses of patients were long-QT syndrome in 6, aborted cardiac arrest with left ventricular non-compaction in 3, hypertrophic cardiomyopathy with sustained ventricular tachycardia in 3, and arrythmogenic right ventricular cardiomyopathy in 1. Revision of the subcutaneous lead was required in 5 patients 2–26 months after the implantation. Appropriate shocks were observed in three patients. Inappropriate shock and lead fractures were observed in one patient during the follow-up period. The failure of therapy was observed in one patient. There were no perioperative complications and no early or late deaths.Conclusion:Subcutaneous defibrillator systems are safe and effective in pediatric patients when the transvenous method is risky and contraindicated. Because the high growth rate in this population leads to lead failures, a close follow-up of this population is essential. (Anatol J Cardiol 2016; 16: 630-4)

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Novel Minimally Invasive, Intrapericardial Implantable Cardioverter Defibrillator Coil System: A Useful Approach to Arrhythmia Therapy in Children

Cited by 54 publications

References 26 publications

Gold nanoparticle-doped biocompatible silk films as a path to implantable thermo-electrically wireless powering devices

Gold nanoparticle-doped biocompatible silk films as a path to implantable thermo-electrically wireless powering devices

Acute and Chronic Performance Evaluation of a Novel Epicardial Pacing Lead Placed by Percutaneous Subxiphoid Approach in a Canine Model

Subcutaneous defibrillator implantation in pediatric patients

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