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Ibrahim SH, Mason PK. Severe Tricuspid Regurgitation in a Patient with a Transvenous Dual-chamber Pacemaker: Considerations for Diagnosis and Management. Card Electrophysiol Clin 2024; 16:157-161. [PMID: 38749635 DOI: 10.1016/j.ccep.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Cardiac implantable electronic device leads can contribute to tricuspid regurgitation and also complicate surgical and transcatheter interventions to manage tricuspid regurgitation. Here we present a case of a patient with sinus node dysfunction and complete heart block who underwent extraction of a right ventricular pacing lead before tricuspid valve surgery. We review the data regarding the contribution of leads to tricuspid regurgitation and the benefits of lead extraction, risks of jailing leads during tricuspid interventions, and pacing considerations around tricuspid valve procedures.
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Affiliation(s)
- Sami H Ibrahim
- University of Virginia, Box 800158, Charlottesville, VA 22908, USA
| | - Pamela K Mason
- University of Virginia, Box 800158, Charlottesville, VA 22908, USA.
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2
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Okazaki M, Sahashi Y, Nagase T, Inoue K, Sekiguchi Y, Nitta J, Shinoda S, Shimizu S, Kuroki M, Isobe M, Mihara T. Inappropriate shock incidence in patients with subcutaneous implantable cardioverter-defibrillators with concomitant cardiac implantable electronic devices: A single-center cohort study. Pacing Clin Electrophysiol 2024; 47:131-138. [PMID: 38010718 DOI: 10.1111/pace.14887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/08/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Subcutaneous implantable cardioverter defibrillators (S-ICDs) are occasionally used in combination with other cardiac implantable electronic devices (CIEDs). However, whether the incidence of inappropriate shock increases in patients with S-ICDs and concomitant CIEDs remains unclear. This study aimed to investigate the association between the concomitant use of CIEDs and the incidence of inappropriate shock in patients with current-generation S-ICDs. METHODS A total of 127 consecutive patients received an S-ICD. Patients were assigned to two groups depending on concomitant use of CIEDs at the time of S-ICD implantation: patients without other CIEDs (non-combined group, 106 patients) and patients with other CIEDs (combined group, 21 patients). CIEDs included pacemakers, implantable cardioverter defibrillators, cardiac resynchronization therapy pacemakers, and cardiac resynchronization therapy defibrillators. The primary outcome was inappropriate shock, defined as a shock other than ventricular arrhythmia. Hazard ratios and 95% confidence intervals were calculated using a time-varying Cox proportional hazards model which was adjusted for age because age differed between the groups and could be a confounder. RESULTS During a median follow-up period of 2.2 years (interquartile range, 1.0-3.4 years), inappropriate shock events occurred in 17 (16%) and five (19%) patients of the non-combined and combined groups, respectively. While the age-adjusted hazard ratio for inappropriate shock was 24% higher in the combined than in the non-combined group (hazard ratio = 1.24, 95% confidence interval, 0.39-3.97), this difference was insignificant (p = .71). CONCLUSION The incidence of inappropriate shock did not differ between patients with and without concomitant use of CIEDs, suggesting that S-ICDs could potentially be combined with other CIEDs without increasing the number of inappropriate shocks. Further studies are warranted to confirm the safety and feasibility of concomitant use of S-ICDs and CIEDs.
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Affiliation(s)
- Makiko Okazaki
- Department of Clinical Engineering, Sakakibara Heart Institute, Fuchu-shi, Tokyo, Japan
- Department of Health Data Science, Yokohama City University Graduate School of Data Science, Yokohama-shi, Kanagawa, Japan
| | - Yuki Sahashi
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu-shi, Japan
| | - Takahiko Nagase
- Department of Cardiology, Sakakibara Heart Institute, Fuchu-shi, Tokyo, Japan
| | - Kanki Inoue
- Department of Cardiology, Sakakibara Heart Institute, Fuchu-shi, Tokyo, Japan
| | - Yukio Sekiguchi
- Department of Cardiology, Sakakibara Heart Institute, Fuchu-shi, Tokyo, Japan
| | - Junichi Nitta
- Department of Cardiology, Sakakibara Heart Institute, Fuchu-shi, Tokyo, Japan
| | - Satoru Shinoda
- Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama-shi, Kanagawa, Japan
| | - Sayuri Shimizu
- Department of Health Data Science, Yokohama City University Graduate School of Data Science, Yokohama-shi, Kanagawa, Japan
| | - Makoto Kuroki
- Department of Health Data Science, Yokohama City University Graduate School of Data Science, Yokohama-shi, Kanagawa, Japan
| | | | - Takahiro Mihara
- Department of Health Data Science, Yokohama City University Graduate School of Data Science, Yokohama-shi, Kanagawa, Japan
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3
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Calvagna GM, Valsecchi S. Simultaneous subcutaneous implantable cardioverter-defibrillator and leadless pacemaker implantation for patients at high risk of infection: a retrospective case series report. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01684-9. [PMID: 37938506 DOI: 10.1007/s10840-023-01684-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The subcutaneous implantable cardioverter defibrillator (S-ICD) and leadless pacemaker (LP) are alternative options for patients at high risk of infection requiring ICD and pacing therapy. In this analysis, we described the simultaneous implantation of S-ICD and LP in patients with high infectious risk. METHODS The study cohort comprised patients referred to our institution for ICD implantation due to high-risk factors of infection. RESULTS Between 2018 and 2022, 13 patients were referred, including 11 with infected ICD and 2 for first ICD implantation in the presence of high-risk factors. In cases of infected ICD, successful extraction was performed using a mechanical dilatation technique. Reimplantation was delayed until resolution of infection with antibiotic therapy. The devices were implanted during a single procedure, with S-ICD implantation following LP placement for verification of sensing adequacy through surface ECG screening. Suitable vectors for sensing during inhibited and ventricular pacing were identified in all patients. Defibrillation testing was effective, and no issues with double counting or undersensing were observed. The postoperative period was uneventful, and during a median follow-up of 35 months, no complications or infections were reported. The median ventricular pacing percentage was 5%, and a single inappropriate shock episode due to myopotential interference was reported and resolved by reprogramming the sensing vector. CONCLUSION Simultaneous implantation of S-ICD and LP is feasible and safe in patients at high risk of infection requiring both ICD and pacing therapy. This combined approach provides an effective solution for these patients.
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Sarubbi B, Ciriello GD, Papaccioli G, Correra A, Romeo E, Grimaldi N, Colonna D, Palma M. Combined subcutaneous implantable cardioverter defibrillator and pacemaker devices in complex congenital heart disease: a single-center experienced based study. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01670-1. [PMID: 37878161 DOI: 10.1007/s10840-023-01670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Subcutaneous implantable cardioverter defibrillators (S-ICD) are widely accepted therapy in congenital heart disease (CHD) patients at risk of life-threatening ventricular arrhythmias or sudden cardiac death (SCD) when pacing is not required. Occasionally, pacemaker (PM)-dependent CHD patients will subsequently develop an indication for a cardioverter defibrillator. The use of S-ICD in complex CHD patients who have had already PM devices implanted implies some specific considerations, as the safety for these patients in unknown and recommendations among physicians may vary widely. METHODS We review the data and studied the indications for S-ICD in complex CHD with previous PM and discuss its usefulness in clinical practice. RESULTS From a large cohort of 345 patients enrolled in the S-ICD Monaldi care registry, which encompass all the patients implanted in the Monaldi Hospital of Naples, we considered 11 consecutive complex CHD patients (10M/1F aged 40.4 ±18.4 years) who underwent S-ICD implant after a previous PM implant, from February 2015 to October 2022. Mean follow-up was 25.5 ± 22 months. All the patients showed a good compliance to the device system with no complications (infections or skin erosions). CONCLUSIONS In complex CHD with already implanted PM devices, S-ICD implant appears to be a safe alternative to PM upgrading to transvenous ICD system, avoiding abandoned leads or life-threatening lead extraction. However, there are important issues with regard to testing and programming that need to be addressed at the time of implantation.
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Affiliation(s)
- Berardo Sarubbi
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
| | | | | | - Anna Correra
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Emanuele Romeo
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Nicola Grimaldi
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Diego Colonna
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Michela Palma
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
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John LA, Karimianpour A, Gold MR. The Role of Subcutaneous ICDs in the Prevention of Sudden Cardiac Death. US CARDIOLOGY REVIEW 2021. [DOI: 10.15420/usc.2021.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The ICD is an important therapy in the prevention of sudden cardiac death. The transvenous-ICD (TV-ICD) has been the primary device used for this purpose. However, mechanical and infectious complications occur with traditional TV-ICDs increasing morbidity and mortality. The subcutaneous-ICD (S-ICD) system was developed to circumvent some of these complications, but S-ICDs have their inherent set of limitations as well. These include inappropriate shock delivery, lack of bradycardia, antitachycardia or CRT pacing therapy and shorter device longevity. The S-ICD is now included in guidelines as an acceptable alternative to TV-ICDs among patients without pacing indications. This review discusses the rationale for S-ICDs by reviewing studies including the PRAETORIAN, PAS and UNTOUCHED trials.
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Affiliation(s)
- Leah A John
- Division of Cardiology, Medical University of South Carolina, Charleston, SC
| | | | - Michael R Gold
- Division of Cardiology, Medical University of South Carolina, Charleston, SC
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto S, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, Mitamura H. JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias. J Arrhythm 2021; 37:709-870. [PMID: 34386109 PMCID: PMC8339126 DOI: 10.1002/joa3.12491] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Abbott N, Bender A, Henrikson C, Miller J, Nazer B, Balaji S. Adverse device-device interaction between pacemaker and subcutaneous implantable cardiac defibrillator. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2021; 44:1944-1948. [PMID: 34296775 DOI: 10.1111/pace.14325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/13/2021] [Accepted: 07/04/2021] [Indexed: 11/29/2022]
Abstract
A 26-year-old patient with prior surgery for Ebstein's anomaly and a pacemaker (placed for post-surgical heart block and poor underlying rhythm) underwent SICD was placement. During defibrillation testing, device-device interaction led to undersensing of ventricular fibrillation with failure to shock. Increasing the pacemaker sensitivity resolved the problem but post shock pacing was unable to capture the heart after both shocks. The patient underwent removal of both the pacemaker and the SICD and placement of a transvenous ICD. Complex device-device interactions can occur in patients who are pacemaker dependent and undergo placement of a SICD.
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Affiliation(s)
- Nicholas Abbott
- Knight Cardiovascular Institute, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Aron Bender
- Knight Cardiovascular Institute, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Charles Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Jared Miller
- Knight Cardiovascular Institute, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Seshadri Balaji
- Department of Pediatric Cardiology, Oregon Health & Science University (OHSU), Doernbecher Children's Hospital, Portland, Oregon, USA
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto SI, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, Mitamura H. JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias. Circ J 2021; 85:1104-1244. [PMID: 34078838 DOI: 10.1253/circj.cj-20-0637] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Haruhiko Abe
- Department of Heart Rhythm Management, University of Occupational and Environmental Health, Japan
| | - Kenji Ando
- Department of Cardiology, Kokura Memorial Hospital
| | - Toshiyuki Ishikawa
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University
| | - Katsuhiko Imai
- Department of Cardiovascular Surgery, Kure Medical Center and Chugoku Cancer Center
| | - Akihiko Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine
| | - Kaoru Okishige
- Department of Cardiology, Yokohama City Minato Red Cross Hospital
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Masahiko Goya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | | | | | - Wataru Shimizu
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School
| | - Morio Shoda
- Department of Cardiology, Tokyo Women's Medical University
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | - Yoshihiro Seo
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | | | - Yuji Nakazato
- Department of Cardiovascular Medicine, Juntendo University Urayasu Hospital
| | - Takashi Nishimura
- Department of Cardiac Surgery, Tokyo Metropolitan Geriatric Hospital
| | - Takashi Nitta
- Department of Cardiovascular Surgery, Nippon Medical School
| | - Shinichi Niwano
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | | | - Yuji Murakawa
- Fourth Department of Internal Medicine, Teikyo University Hospital Mizonokuchi
| | - Teiichi Yamane
- Department of Cardiology, Jikei University School of Medicine
| | - Takeshi Aiba
- Division of Arrhythmia, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koichi Inoue
- Division of Arrhythmia, Cardiovascular Center, Sakurabashi Watanabe Hospital
| | - Yuki Iwasaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School
| | - Yasuya Inden
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Kikuya Uno
- Arrhythmia Center, Chiba Nishi General Hospital
| | - Michio Ogano
- Department of Cardiovascular Medicine, Shizuoka Medical Center
| | - Masaomi Kimura
- Advanced Management of Cardiac Arrhythmias, Hirosaki University Graduate School of Medicine
| | | | - Shingo Sasaki
- Department of Cardiology and Nephrology, Hirosaki University Graduate School of Medicine
| | | | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University
| | - Tsugutoshi Suzuki
- Departments of Pediatric Electrophysiology, Osaka City General Hospital
| | - Yukio Sekiguchi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Kyoko Soejima
- Arrhythmia Center, Second Department of Internal Medicine, Kyorin University Hospital
| | - Masahiko Takagi
- Division of Cardiac Arrhythmia, Department of Internal Medicine II, Kansai Medical University
| | - Masaomi Chinushi
- School of Health Sciences, Faculty of Medicine, Niigata University
| | - Nobuhiro Nishi
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hitoshi Hachiya
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | | | - Yasushi Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School Chiba-Hokusoh Hospital
| | - Aya Miyazaki
- Department of Pediatric Cardiology, Congenital Heart Disease Center, Tenri Hospital
| | - Tomoshige Morimoto
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
| | - Hiro Yamasaki
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | | | - Takeshi Kimura
- Department of Cardiology, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School
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Gauthey A, Calle S, Accinelli S, Depuydt P, Garnir Q, Scavée C, Marchandise S, Wauters A, Bordachar P, de Pooter J, le Polain de Waroux JB. His bundle pacing for newly acquired pacing needs in patients implanted with a subcutaneous implantable cardioverter defibrillator: A feasibility study based on the automated screening score and clinical cases. J Cardiovasc Electrophysiol 2020; 31:1793-1800. [PMID: 32412155 DOI: 10.1111/jce.14566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Management of subcutaneous implantable cardioverter defibrillator (S-ICD) patients with newly acquired pacing needs remains problematic. His bundle pacing (HBP) allows for cardiac pacing without significant changes in the QRS morphology. We hypothesized that HBP does not alter S-ICD sensing and functions. METHODS Twenty consecutive patients were implanted with a HB pacemaker. Among them, 17 demonstrated successful His recruitment and were prospectively screened with the automated screening tool (AST). Results of screenings performed immediately after implant and during follow-up, during intrinsic rhythm and while pacing from all available pacing configurations, were compared using the AST score. Positive-screening tests were defined by greater than or equal to 1 positive vector. RESULTS Among the 17 patients successfully implanted (male: 41%; mean age: 73), 13 presented an indication of ventricular pacing and four of cardiac resynchronization. Absolute AST scores during both HBP (all configurations) and intrinsic rhythm were similar (p: NS). Due to left bundle branch block correction, HBP resulted in higher number of positive vectors (AST ≥ 100). AST scores were higher during HBP when compared with right ventricular pacing (RVP) (primary vector: 272 [16; 648] vs 4.6 [0.8; 16.2]; P = .003; secondary vector: 569 [183; 1186] vs 1.5 [0.7; 8.3]; P < .0001; alternate vector: 44 [2;125] vs 4.8 [0.9; 9.3]; P = .02) and resulted in a much higher number of positive vectors. Up to 90% of the patients had a positive-screening test during HBP. This passing rate was higher when compared RVP (17%; P < .0001). CONCLUSION HBP restores normal intrinsic conduction and minimally modifies the surface electrocardiograph and subcutaneous electrograms. When ventricular pacing is needed, HBP might represent an ideal pacing option for patients implanted with a S-ICD.
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Affiliation(s)
- Anaïs Gauthey
- Division of Cardiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Simon Calle
- Heart Center, Gent University Hospital, Ghent, Belgium
| | - Stefano Accinelli
- Division of Development, Boston Scientific Employee, Diegem, Belgium
| | - Philippe Depuydt
- Division of Development, Boston Scientific Employee, Diegem, Belgium
| | - Quentin Garnir
- Division of Cardiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Scavée
- Division of Cardiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Sébastien Marchandise
- Division of Cardiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Aurélien Wauters
- Division of Cardiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Bordachar
- IHU Lyric, Electrophysiology and Heart Modeling Institute, Université de Bordeaux, Pessac, France
| | - Jan de Pooter
- Heart Center, Gent University Hospital, Ghent, Belgium
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10
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Hasebe H, Yokoya T, Murakoshi N, Kurebayashi N. Pilsicainide Administration Unmasks a Phenotype of Brugada Syndrome in a Patient with Overlap Syndrome due to the E1784K SCN5A Mutation. Intern Med 2020; 59:83-87. [PMID: 31484910 PMCID: PMC6995720 DOI: 10.2169/internalmedicine.3430-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Mutations in the cardiac sodium channel SCN5A can cause phenotypic overlap syndrome of long QT syndrome and Brugada syndrome. However, Brugada-type ST elevations in patients with overlap syndrome are often concealed, which creates a diagnostic challenge. A 38-year-old man was admitted due to ventricular fibrillation (VF). The 12-lead electrocardiogram showed a prolonged QT interval and saddleback-type ST elevation. Pilsicainide administration induced coved-type ST elevation and VF triggered by a single premature ventricular contraction. A genetic analysis showed an SCN5A c.5350G>A p.E1784K mutation. The present case suggests the importance of a drug administration test being performed in the clinical management of overlap syndrome.
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Affiliation(s)
- Hideyuki Hasebe
- Division of Arrhythmology, Shizuoka Saiseikai General Hospital, Japan
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Japan
| | - Tomoyo Yokoya
- Division of Arrhythmology, Shizuoka Saiseikai General Hospital, Japan
| | - Nobuyuki Murakoshi
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Japan
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11
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Combined leadless pacemaker and subcutaneous implantable cardioverter-defibrillator to manage recurrent transvenous system failures. J Electrocardiol 2019; 54:43-46. [PMID: 30870634 DOI: 10.1016/j.jelectrocard.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/20/2019] [Accepted: 03/05/2019] [Indexed: 11/21/2022]
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Sharma S, Nand NP, Hematpour K, Reddy SK, Salas de Armas IA, Patel MK. Implantation of left atrial-ventricular epicardial pacemaker system and subcutaneous implantable cardioverter-defibrillator in a single setting: The "extravascular" cardiac resynchronization therapy. HeartRhythm Case Rep 2019; 5:354-358. [PMID: 31341775 PMCID: PMC6630148 DOI: 10.1016/j.hrcr.2019.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Saumya Sharma
- Department of Advanced Cardiopulmonary Therapies and Transplantation (ACTAT), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Nikita P Nand
- Department of Advanced Cardiopulmonary Therapies and Transplantation (ACTAT), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Khashayar Hematpour
- Department of Advanced Cardiopulmonary Therapies and Transplantation (ACTAT), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Sunil K Reddy
- Department of Advanced Cardiopulmonary Therapies and Transplantation (ACTAT), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Ismael A Salas de Armas
- Department of Advanced Cardiopulmonary Therapies and Transplantation (ACTAT), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Manish K Patel
- Department of Advanced Cardiopulmonary Therapies and Transplantation (ACTAT), The University of Texas Health Science Center at Houston, Houston, Texas
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Al-Ghamdi B. Subcutaneous Implantable Cardioverter Defibrillators: An Overview of Implantation Techniques and Clinical Outcomes. Curr Cardiol Rev 2019; 15:38-48. [PMID: 30014805 PMCID: PMC6367695 DOI: 10.2174/1573403x14666180716164740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/22/2022] Open
Abstract
Sudden Cardiac Death (SCD) is a significant health problem worldwide. Multiple randomized controlled trials have shown that Implantable Cardioverter Defibrillators (ICDs) are effective life-saving management option for individuals at risk of SCD in both primary and secondary prevention. Although the conventional transvenous ICDs (TV-ICDs) are safe and effective, there are potential complications associated with its use, including localized pocket or wound infection or systematic infection, a vascular access related complication such as pneumothorax, and venous thrombosis, and lead related complications such as dislodgement, malfunction, and perforation. Furthermore, transvenous leads placement may not be feasible in certain patients like those with venous anomaly or occlusion, or with the presence of intracardiac shunts. Transvenous leads extraction, when needed, is associated with considerable morbidity & mortality and requires significant skills and costs. Totally subcutaneous ICD (S-ICD) is designed to afford the same life-saving benefit of the conventional TV-ICDs while avoiding the shortcomings of the TV-leads and to simplify the implant techniques and hence expand the use of ICDs in clinical practice. It becomes commercially available after receiving CE mark in 2009, and its use increased significantly after its FDA approval in 2012. This review aims to give an overview of the S-ICD system components, implantation procedure, clinical indications, safety, efficacy, and future directions.
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Affiliation(s)
- Bandar Al-Ghamdi
- Heart Center, College of Medicine, King Faisal Specialist Hospital & Research Centre, Zahrawi St, Al Maather, Riyadh 12713, Saudi Arabia.,Alfaisal University, College of Medicine, King Faisal Specialist Hospital & Research Centre, Zahrawi St, Al Maather, Riyadh 12713, Saudi Arabia
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14
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Kawabata M, Goya M, Takahashi Y, Maeda S, Yagishita A, Shirai Y, Kaneko M, Shiohira S, Hirao K. Candidacy for a Subcutaneous Implantable Cardioverter Defibrillator in Patients with Cardiac Resynchronization Therapy. Int Heart J 2018; 59:951-958. [PMID: 30101850 DOI: 10.1536/ihj.17-550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In patients requiring an implantable cardioverter defibrillator (ICD), the combined use of a prior pacemaker and a subcutaneous ICD (S-ICD) could be an alternative treatment option to implantation of new leads or upgrading of pacemakers to an ICD if vascular access is limited. Here, we assessed the prevalence of S-ICD's eligibility according to surface electrogram screening in those receiving cardiac resynchronization therapy (CRT). S-ICD's eligibility was assessed in patients with a CRT pacemaker or a CRT defibrillator using the S-ICD template screening tool. Eligibility was defined as fulfillment of the template in both supine and upright positions in one or more leads during biventricular pacing. Among 44 patients (34 men, age: 67 ± 12), 36 (82%) were found to be eligible. The T/QRS amplitude ratio in lead II was significantly lower in those who were eligible (0.31 ± 0.16 versus 0.44 ± 0.18 in the ineligible group, P = 0.04). The lead position, underlying disease, and other electrocardiographic findings were not different between those who were eligible and those who were not. The majority of patients with biventricular pacing were eligible for S-ICD based on current screening tests and may benefit from this treatment. Further study is required.
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Affiliation(s)
| | - Masahiko Goya
- Heart Rhythm Center, Tokyo Medical and Dental University
| | | | - Shingo Maeda
- Heart Rhythm Center, Tokyo Medical and Dental University
| | | | | | | | | | - Kenzo Hirao
- Heart Rhythm Center, Tokyo Medical and Dental University
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15
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Kossidas K, Kalman R, Follis WP, Cooper JM. Managing cross talk between a subcutaneous implantable cardioverter-defibrillator and a dual-chamber unipolar pacemaker system. HeartRhythm Case Rep 2017; 3:579-583. [PMID: 29296580 PMCID: PMC5741814 DOI: 10.1016/j.hrcr.2017.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Konstantinos Kossidas
- Electrophysiology Section, University of Michigan Health System, Ann Arbor, Michigan
| | - Richard Kalman
- Electrophysiology Section, Temple University Health System, Philadelphia, Pennsylvania
| | - William P. Follis
- Electrophysiology Section, Temple University Health System, Philadelphia, Pennsylvania
| | - Joshua M. Cooper
- Electrophysiology Section, Temple University Health System, Philadelphia, Pennsylvania
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16
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RAVIELE ANTONIO, ROSSILLO ANTONIO. Combined Use of Subcutaneous ICD and Pacemakers: The Beginning of a New Era? J Cardiovasc Electrophysiol 2017; 28:549-551. [DOI: 10.1111/jce.13196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- ANTONIO RAVIELE
- ALFA-Alliance to Fight Atrial fibrillation; Venice-Mestre Italy
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17
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Ip JE, Wu MS, Kennel PJ, Thomas G, Liu CF, Cheung JW, Markowitz SM, Lerman BB. Eligibility of Pacemaker Patients for Subcutaneous Implantable Cardioverter Defibrillators. J Cardiovasc Electrophysiol 2017; 28:544-548. [PMID: 28185354 DOI: 10.1111/jce.13182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 01/12/2017] [Accepted: 01/30/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The subcutaneous implantable cardioverter defibrillator (ICD) has emerged as a viable therapeutic option for patients who are deemed high risk for sudden cardiac death. Previous studies have shown that 7-15% of patients are not candidates for the S-ICD based on their intrinsic QRS/T-wave morphology. Presently, it is not known if the S-ICD can be considered as supplementary therapy in patients who are ventricularly paced. We sought to determine the proportion of ventricularly paced patients who would qualify for an S-ICD. METHODS AND RESULTS We evaluated 100 patients with transvenous pacemakers/ICDs, including 25 biventricular devices to determine S-ICD candidacy during right ventricular (RV) pacing and biventricular pacing based on the recommended QRS:T-wave ratio screening template. Fifty-eight percent of patients qualified for an S-ICD based on their QRS morphology during ventricular pacing. More patients during biventricular pacing met criteria compared to during RV pacing alone (80% vs. 46%, P <0.01). Patients that were paced from the RV septum were more likely to qualify compared to those paced from the RV apex (67% vs. 37%, respectively, P <0.01). CONCLUSION While S-ICD implantation may be considered as supplemental therapy in select patients with preexisting transvenous devices, relatively fewer candidates who are paced from the RV apex qualify. QRS morphologies generated from biventricular pacing as well as from septal RV pacing are more likely to screen in based on the recommended S-ICD template.
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Affiliation(s)
- James E Ip
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - Michael S Wu
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - Peter J Kennel
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - George Thomas
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - Christopher F Liu
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - Jim W Cheung
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - Steven M Markowitz
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
| | - Bruce B Lerman
- Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, USA
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HUANG JASON, PATTON KRISTENK, PRUTKIN JORDANM. Concomitant Use of the Subcutaneous Implantable Cardioverter Defibrillator and a Permanent Pacemaker. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:1240-1245. [DOI: 10.1111/pace.12955] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 08/19/2016] [Accepted: 09/20/2016] [Indexed: 11/29/2022]
Affiliation(s)
- JASON HUANG
- Division of Cardiology, Department of Medicine; University of Washington; Seattle Washington
| | - KRISTEN K. PATTON
- Division of Cardiology, Department of Medicine; University of Washington; Seattle Washington
| | - JORDAN M. PRUTKIN
- Division of Cardiology, Department of Medicine; University of Washington; Seattle Washington
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Panna ME, Miles WM. The Subcutaneous Implantable Cardioverter-Defibrillator: A Practical Review and Real-World Use and Application. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2016. [DOI: 10.15212/cvia.2015.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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20
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Lewis GF, Gold MR. Safety and Efficacy of the Subcutaneous Implantable Defibrillator. J Am Coll Cardiol 2016; 67:445-454. [DOI: 10.1016/j.jacc.2015.11.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/05/2015] [Indexed: 10/22/2022]
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21
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22
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Mondésert B, Dubuc M, Khairy P, Guerra PG, Gosselin G, Thibault B. Combination of a leadless pacemaker and subcutaneous defibrillator: First in-human report. HeartRhythm Case Rep 2015; 1:469-471. [PMID: 28491609 PMCID: PMC5419724 DOI: 10.1016/j.hrcr.2015.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Blandine Mondésert
- Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Marc Dubuc
- Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Paul Khairy
- Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Peter G Guerra
- Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Gilbert Gosselin
- Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Bernard Thibault
- Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montreal, Canada
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Frommeyer G, Dechering DG, Zumhagen S, Köbe J, Eckardt L, Reinke F. Limitations in S-ICD therapy: reasons for system explantation. Clin Res Cardiol 2015; 104:902-7. [DOI: 10.1007/s00392-015-0880-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022]
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