Device interaction between cardiac contractility modulation (CCM) and subcutaneous defibrillator (S‐ICD)

Abstract

Combined implantation of cardiac contractility modulation (CCM) with subcutaneous implantable cardioverter-defibrillator (S-ICD) appears a suitable option to reduce the amount of intracardiac leads and complications for patients. Here we report on a patient with ischemic cardiomyopathy carrying an S-ICD in which a CCM device was implanted. During crosstalk testing post-CCM implantation, the S-ICD misannotated QRS complexes and T waves. The problem was solved through reprogramming the CCM, while preserving S-ICD functionality and improving heart failure symptoms. In conclusion, S-ICD combined with CCM seems to be a good and safe option for patients when device interference is being ruled out.

A tale of two technologies: Use of cardiac contractility modulator with wearable cardiac defibrillator

“…To date, there has been little data analyzing interactions between CCM and WCDs. 3 Although no interactions occurred in this case, we highlight a theoretical interaction between CCM therapy and LifeVest. The LifeVest could theoretically undersense QRS complexes during these 2-second periods when CCM therapy periodically turns off.…”

“…Patients with a concomitant cardiovascular implantable electronic device, including implantable cardioverter-defibrillators and pacemakers, require provocative testing of CCM therapy at the time of CCM implant for cardiovascular implantable electronic device oversensing of CCM signals. 3 , 4 There is a paucity of data describing the interactions between the LifeVest and CCM devices.…”

S-ICD Implantation "Tips and Tricks"

“…Other devices that may interact with S-ICD include pacing systems for deep brain stimulation, cardiac contractility modulation systems, baroreceptor stimulators and vagus nerve stimulators. All of those devices were described in the context of possible interference [ 115 , 116 ]. Some of them can be applied in selected patients [ 117 , 118 , 119 , 120 ], but a case-by-case analysis and thorough investigation of any possible cross-talk is crucial in those patients, and should involve in-depth analysis with programmers for all implanted devices and various possible current outputs of the devices.…”

Cardiac contractility modulation and subcutaneous defibrillator (S‐ICD): First experience with simultaneous implantation

“…(S-ICD) can be considered for patients at high risk of infection, bradycardia, without appropriate venous access, and that does not need biventricular pacing and/or anti-tachycardia pacing. 4 Current studies and case reports have proved the combining implantation of CCM with S-ICD is an appropriate choice for patients who don't require pacemaker stimulation, [5][6][7] and which is safe and successful in the long-term follow-up cohort study. 8 These patients, however, had CCM or S-ICD implanted first, followed by another device.…”

“…Current studies and case reports have proved the combining implantation of CCM with S‐ICD is an appropriate choice for patients who don't require pacemaker stimulation, 5–7 and which is safe and successful in the long‐term follow‐up cohort study 8 . These patients, however, had CCM or S‐ICD implanted first, followed by another device.…”