Successful management of wound dehiscence after implantation of a subcutaneous implantable cardioverter-defibrillator without device removal Mitsuhiro.

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Presentation transcript:

Successful management of wound dehiscence after implantation of a subcutaneous implantable cardioverter-defibrillator without device removal Mitsuhiro Fukata, MD, PhD, Takeshi Arita, MD, PhD, Hideki Kadota, MD, PhD, Keita Odashiro, MD, PhD, Toru Maruyama, MD, PhD, Koichi Akashi, MD, PhD HeartRhythm Case Reports Volume 3, Issue 9, Pages 415-417 (September 2017) DOI: 10.1016/j.hrcr.2017.06.006 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Photographs of the surgical wound at the upper sternum on postoperative day (POD)-3 (A), POD-31 (B: before debridement; C: after debridement), POD-35 (D), POD-49 (E), and POD-70 (F, G). HeartRhythm Case Reports 2017 3, 415-417DOI: (10.1016/j.hrcr.2017.06.006) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Subcutaneous implantable cardioverter-defibrillator electrogram in a secondary vector during shoulder joint motion on postoperative day 31 (A) and 8 months after implantation (B). A: Noises induced by body motion were mainly inappropriately recognized as ventricular activation (marked as “S” under the electrogram), and 1 noise just before 6 seconds after starting the recording was recognized as ventricular tachyarrhythmia (marked as “T” under the electrogram). Only 1 noise during this recording was appropriately recognized as noise (marked as “N” under the electrogram). B: Noise induced by body motion was appropriately discriminated. Only 1 true ventricular activation at sinus rhythm during recording was interfered by noise (marked as “N” under the electrogram). HeartRhythm Case Reports 2017 3, 415-417DOI: (10.1016/j.hrcr.2017.06.006) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 Time course of blood examinations. The white blood cell count and C-reactive protein level both transiently increased after subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, but rapidly decreased to normal ranges within 1 week. bFGF = basic fibroblast growth factor; CEZ = cefazolin; MINO = minocycline; POD = postoperative day. HeartRhythm Case Reports 2017 3, 415-417DOI: (10.1016/j.hrcr.2017.06.006) Copyright © 2017 Heart Rhythm Society Terms and Conditions