Single-Incision and Single-Element Array Electrode to Lower the Defibrillation Threshold

Kühlkamp, Volker; Khalighi, Kourosh; Dörnberger, Volker; Ziemer, Gerhard

doi:10.1016/s0003-4975(97)00811-4

Cited by 7 publications

(2 citation statements)

References 7 publications

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“…The DFT is the amount of minimal shock needed to terminate VF with at least 1 failure with lower energy shock. 5 The reasons for high DFT in this patient were chronic renal failure and biventricular thickening due to amyloid protein deposition in the myocardium. Patients with high DFTs represent a small, but significant population among those with ICDs.…”

Section: Discussionmentioning

confidence: 76%

Cardiac Amyloidosis Treated with an Implantable Cardioverter Defibrillator and Subcutaneous Array Lead System: Report of a Case and Literature Review

Dhoble

Khasnis

Olomu

et al. 2009

Clinical Cardiology

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BackgroundPreventing ventricular arrhythmias in patients with cardiac amyloidosis is challenging since the amyloid protein deposition in the myocardium may interfere with the normal cardiac electric excitation. Most of these patients succumb to either progressive congestive heart failure, or sudden cardiac death (SCD). Implantable Cardioverter Defibrillator (ICD) offers a near sure means of preventing SCD.HypothesisMyocardial infiltration with amyloid results in elevated defibrillation threshold (DFT). Intra‐operative strategies may fail to lower DFT during implantation.MethodsWe present a case of a 64‐year‐old female who had cardiac amyloidosis, and was successfully treated with an ICD and a subcutaneous array lead system.ConclusionA subcutaneous array lead system is useful in reducing the DFT, and can terminate ventricular tachycardia or fibrillation by allowing more energy delivery and efficient defibrillation. Copyright © 2009 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 76%

Cardiac Amyloidosis Treated with an Implantable Cardioverter Defibrillator and Subcutaneous Array Lead System: Report of a Case and Literature Review

Dhoble

Khasnis

Olomu

et al. 2009

Clinical Cardiology

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“…Former studies proved that such a solution offers a mean DFT reduction of 20% to 60%, depending on the electrode model [6–9]. …”

Section: Introductionmentioning

confidence: 99%

Implantation of additional subcutaneous array electrode reduces defibrillation threshold in ICD patients – preliminary results

Kempa¹,

Budrejko²,

Drelich³

et al. 2013

aoms

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IntroductionAmong the recipients of implantable cardioverter-defibrillators (ICDs), there is a group of patients in whom the defibrillation threshold (DFT) is too high to enable a sufficient safety margin between the DFT and the maximal available output of the device. The aim of the study was to investigate the ability of an additionally implanted single-coil subcutaneous array electrode to reduce the DFT in such patients.Material and methodsMedtronic 6996SQ electrode was implanted in 15 patients selected from our follow-up group of 741 ICD patients: 10 of them had insufficient post-implant DFT safety margin, and 5 had ineffective first maximal energy shock as recorded by the device. In 6 cases the patients had CRT-D devices, in 5 cases – dual-chamber ICDs, and in 4 cases – single-chamber ICDs. In all patients but one the defibrillating electrode was single-coil. In one patient it was dual-coil. The underlying disease was coronary artery disease in 10 patients, dilated cardiomyopathy in 4 patients and hypertrophic cardiomyopathy in 1 patient.ResultsThe subcutaneous electrode was successfully implanted in all the patients qualified for the procedure. No technical issues or perioperative complications were observed. Mean DFT was reduced from 33.3 ±4.1 J before the procedure to 25.3 ±4.4 J after the implantation procedure (p < 0.01).ConclusionsOur results show that the use of a single-coil subcutaneous electrode to reduce the DFT is a safe and effective procedure. Further studies are necessary to confirm these results.

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Indications for implantable cardioverter defibrillator therapy, device, and lead selection

Cohen

Etheridge

2017

Cardiac Pacing and Defibrillation in Pediatric and Congenital Heart Disease

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Single-Incision and Single-Element Array Electrode to Lower the Defibrillation Threshold

Cited by 7 publications

References 7 publications

Cardiac Amyloidosis Treated with an Implantable Cardioverter Defibrillator and Subcutaneous Array Lead System: Report of a Case and Literature Review

Cardiac Amyloidosis Treated with an Implantable Cardioverter Defibrillator and Subcutaneous Array Lead System: Report of a Case and Literature Review

Implantation of additional subcutaneous array electrode reduces defibrillation threshold in ICD patients – preliminary results

Indications for implantable cardioverter defibrillator therapy, device, and lead selection

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