HeartRhythm Case Reports

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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:

HeartRhythm Case Reports Implantation of left atrial-ventricular epicardial pacemaker system and subcutaneous implantable cardioverter defibrillator in a single setting: The “Extravascular” cardiac resynchronization therapy Saumya Sharma, MD, Nikita P. Nand, MD, Khashayar Hematpour, MD, Sunil K. Reddy, MD, Ismael A. Salas de Armas, MD, Manish K. Patel, MD HeartRhythm Case Reports DOI: 10.1016/j.hrcr.2019.02.010 Copyright © 2019 Heart Rhythm Society Terms and Conditions

Figure 1 Epicardial leads and the S-ICD pocket Image showing the operative field of a patient in right lateral decubitus position with left arm extended. 1A shows the left lateral thoracotomy incision. 1B is the outline of the S-ICD pocket created using the same incision. 1C shows the epicardial pacemaker leads that are tunneled to the sub-rectus sheath. HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.02.010) Copyright © 2019 Heart Rhythm Society Terms and Conditions

Figure 2A The Extravascular CRT Chest radiograph after implantation of subcutaneous implantable cardioverter defibrillator (S-ICD) and left atrial-ventricular epicardial pacemaker system. The epicardial leads are fixed to the free wall of the left atrium (black arrowhead) and left ventricle (black arrow). The S-ICD lead is placed in a left parasternal position (white arrow). The generator of the S-ICD is positioned in a subcutaneous pocket at the lower left-lateral thorax.Figure 2B: The Extravascular CRT Chest radiograph after implantation of the extravascular CRT. The figure demonstrates the optimal position of the S-ICD lead placed in the left parasternal position (white arrow). The epicardial leads are fixed to the free wall of the left ventricle (black arrows). The generator of the S-ICD is positioned in a subcutaneous pocket at the lower left-lateral thorax. HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.02.010) Copyright © 2019 Heart Rhythm Society Terms and Conditions