Decreased Defibrillation Threshold and Minimized Myocardial Damage With Left Axilla Implantable Cardioverter Defibrillator Implantation

Noro, Mahito; Zhu, Xin; Enomoto, Yoshinari; Oikawa, Yasuhiro; Tatsunami, Hiroyuki; Ishii, Rina; Toyoda, Yasutake; Asami, Masatoshi; Sahara, Naohiko; Takagi, Takahito; Narabayashi, Yuriko; Hashimoto, H; Ito, Naoshi; Kujime, Shingo; Sakai, Tsuyoshi; Nakamura, K; Saruta, Takao; Abe, Haruhiko; Sugi, Kaoru

doi:10.1253/circj.cj-15-1258

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…An in silico study reported a lower defibrillation threshold for right-sided than for left-sided S-ICD lead placement. 29 An observational study in a general S-ICD population 30 demonstrated similar rates of successful defibrillation with the first 65J shock (79% left-sided and 73% right-sided lead; P=NS), and similar rates of ineffective shocks (2.9% left-sided and 1.9% right-sided lead; P=NS). A randomized controlled trial is needed before right-sided S-ICD lead placement can be recommended as preferential in ACHD.…”

Section: Nearly Half Of the Contemporary Achd Population Is Ineligible For S-icdmentioning

confidence: 92%

Eligibility for subcutaneous implantable cardioverter-defibrillator in congenital heart disease

et al. 2020

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Section: Nearly Half Of the Contemporary Achd Population Is Ineligible For S-icdmentioning

confidence: 92%

Eligibility for subcutaneous implantable cardioverter-defibrillator in congenital heart disease

et al. 2020

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“…Potential side effects of this procedure are, in addition to the anesthetic risk, skin burns, heart block, prolonged sinus arrest, ventricular pro-arrhythmia, epidermal necrosis, and apnea (Pagan-Carlo et al, 1997;Kowey et al, 1998;Yava et al, 2012). However, while most studies show no relevant myocardial damage from external eCV (Georges et al, 1996;Neumayr et al, 1997;Greaves and Crake, 1998;Walcott et al, 2003;Piechota et al, 2007;Lobo et al, 2018), there is injury to the myocardium by internal eCV (Noro et al, 2016;Stieger et al, 2018).…”

Section: Electrical Cardioversionmentioning

confidence: 99%

Current Drug Treatment Strategies for Atrial Fibrillation and TASK-1 Inhibition as an Emerging Novel Therapy Option

et al. 2021

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Atrial fibrillation (AF) is the most common sustained arrhythmia with a prevalence of up to 4% and an upwards trend due to demographic changes. It is associated with an increase in mortality and stroke incidences. While stroke risk can be significantly reduced through anticoagulant therapy, adequate treatment of other AF related symptoms remains an unmet medical need in many cases. Two main treatment strategies are available: rate control that modulates ventricular heart rate and prevents tachymyopathy as well as rhythm control that aims to restore and sustain sinus rhythm. Rate control can be achieved through drugs or ablation of the atrioventricular node, rendering the patient pacemaker-dependent. For rhythm control electrical cardioversion and pharmacological cardioversion can be used. While electrical cardioversion requires fasting and sedation of the patient, antiarrhythmic drugs have other limitations. Most antiarrhythmic drugs carry a risk for pro-arrhythmic effects and are contraindicated in patients with structural heart diseases. Furthermore, catheter ablation of pulmonary veins can be performed with its risk of intraprocedural complications and varying success. In recent years TASK-1 has been introduced as a new target for AF therapy. Upregulation of TASK-1 in AF patients contributes to prolongation of the action potential duration. In a porcine model of AF, TASK-1 inhibition by gene therapy or pharmacological compounds induced cardioversion to sinus rhythm. The DOxapram Conversion TO Sinus rhythm (DOCTOS)-Trial will reveal whether doxapram, a potent TASK-1 inhibitor, can be used for acute cardioversion of persistent and paroxysmal AF in patients, potentially leading to a new treatment option for AF.

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“…ICDs are superior to antiarrhythmic drug therapy for prevention of sudden cardiac death 60,116,123 . The position of defibrillation coils is not important provided the area between anode and cathode covers 90 % of the heart tissue with a voltage gradient of more than 5 volts per meter 129 . An ICD delivers pacing therapy when needed, since bradycardia frequently develops immediately after a shock.…”

Section: Icdmentioning

confidence: 99%

Technological and Clinical Challenges in Lead Placement for Cardiac Rhythm Management Devices

et al. 2019

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Cardiac Cardiac disease is a leading cause of death worldwide. Disturbance in the conduction system of the heart may trigger or aggravate heart dysfunction, affecting the efficiency of the heart, and lead to heart failure or cardiac arrest. Patients may require implantable cardiac rhythm management devices (ICRMDs) to maintain or restore the heart rhythm.ICRMDs have undergone important improvements, yet limitations still exist, presenting important technological challenges. Most ICRMDs consist of a subcutaneous control unit and intracardiac electrodes. The leads, which connect the electrodes to the control unit, are usually placed transvenously through the subclavian veins. Various locations inside the heart are used for placement of electrodes, depending on the specific condition. Some of the limitations to effective pacemaker therapy are associated with placement and location of the leads. Various approaches have been developed to overcome these challenges, such as multisite pacing and leadless solutions. This paper aims to review the state of the art for the selection of placement sites for pacemakers, implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy devices (CRT) devices and discuss potential technological advancements to improve the results of ICRMD-therapy including development av leadless technology.

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Decreased Defibrillation Threshold and Minimized Myocardial Damage With Left Axilla Implantable Cardioverter Defibrillator Implantation

Abstract: Clinically and theoretically, the left axilla was shown to be an improved ICD implantation site that may reduce DFT and lessen myocardial damage due to shock. Lower DFT also facilitates less myocardial damage, as a result of the lower shock required.

Cited by 6 publications

References 22 publications

Eligibility for subcutaneous implantable cardioverter-defibrillator in congenital heart disease

Eligibility for subcutaneous implantable cardioverter-defibrillator in congenital heart disease

Current Drug Treatment Strategies for Atrial Fibrillation and TASK-1 Inhibition as an Emerging Novel Therapy Option

Technological and Clinical Challenges in Lead Placement for Cardiac Rhythm Management Devices

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