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Implantation of the subcutaneous implantable cardioverter-defibrillator with retroperitoneal generator placement in a child with hypoplastic left heart.

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Presentation transcript:

Volume 11, Issue 2, Pages 210-215 (February 2014) Implantable intravascular defibrillator: Defibrillation thresholds of an intravascular cardioverter-defibrillator compared with those of a conventional ICD in humans Petr Neuzil, MD, PhD, Vivek Y. Reddy, MD, Bela Merkely, MD, PhD, Laszlo Geller, MD, PhD, Levente Molnar, MD, Jacek Bednarek, MD, PhD, Krzysztof Bartus, MD, PhD, Mark Richey, BS, T.J.Ransbury BSEE, William.E. Sanders, MD, MBA, FHRS Heart Rhythm Volume 11, Issue 2, Pages 210-215 (February 2014) DOI: 10.1016/j.hrthm.2013.10.035 Copyright © 2014 Terms and Conditions

Figure 1 Typical position of the PICD in the vasculature. Arrows mark the anchoring region, pulse generator, and RV connection of the device. IVC = inferior vena cava; PICD = percutaneous intravascular cardioverter-defibrillator; RV = right ventricle/ventricular; SVC = superior vena cava. Heart Rhythm 2014 11, 210-215DOI: (10.1016/j.hrthm.2013.10.035) Copyright © 2014 Terms and Conditions

Figure 2 Electrode systems and resulting defibrillation vectors (red arrows). A: PICD vector, RV (+) → IVC (−) + SVC (−). Also shown is the connector that connects the PICD RV lead to the conventional RV lead used in DFT testing. B: Conventional type vector, RV (+) → SVC (−) + active can (−). ICD = implantable cardioverter-defibrillator; IVC = inferior vena cava; PICD = percutaneous intravascular cardioverter-defibrillator; RV = right ventricle/ventricular; SVC = superior vena cava. Heart Rhythm 2014 11, 210-215DOI: (10.1016/j.hrthm.2013.10.035) Copyright © 2014 Terms and Conditions

Figure 3 Trial flowchart. DFT = defibrillation threshold; EF = ejection fraction; ICD = implantable cardioverter-defibrillator; MI = myocardial infarction; NSR = normal sinus rhythm; PICD = percutaneous intravascular cardioverter-defibrillator. Heart Rhythm 2014 11, 210-215DOI: (10.1016/j.hrthm.2013.10.035) Copyright © 2014 Terms and Conditions

Figure 4 The method of connecting the PICD RV lead to the conventional RV lead that was used in the testing of both devices. ICD = implantable cardioverter-defibrillator; PICD = percutaneous intravascular cardioverter-defibrillator; RV = right ventricle/ventricular. Heart Rhythm 2014 11, 210-215DOI: (10.1016/j.hrthm.2013.10.035) Copyright © 2014 Terms and Conditions

Figure 5 Defibrillation threshold testing protocol. Heart Rhythm 2014 11, 210-215DOI: (10.1016/j.hrthm.2013.10.035) Copyright © 2014 Terms and Conditions