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Swerdlow CD. Implantable cardioverter-defibrillator alert in dextrocardia with transposition of the great arteries. Heart Rhythm 2024:S1547-5271(24)02878-9. [PMID: 38971415 DOI: 10.1016/j.hrthm.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/08/2024]
Affiliation(s)
- Charles D Swerdlow
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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2
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Dasgupta S, Thomas K, Johnsrude C. Subcutaneous cardioverter-defibrillator implantation in an adult with congenital heart disease and left infra-mammary pacemaker. Indian Pacing Electrophysiol J 2024; 24:111-113. [PMID: 38169171 PMCID: PMC11010441 DOI: 10.1016/j.ipej.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/07/2023] [Accepted: 12/30/2023] [Indexed: 01/05/2024] Open
Abstract
The approach/type of an implantable cardioverter defibrillator (ICD) is determined by the underlying cardiac anatomy, venous access, and pre-existing cardiac implantable electronic devices. We describe a case of subcutaneous ICD implantation in an adult with congenital heart disease (CHD) with a pre-existing inframammary transvenous pacemaker. This was preferred over adding a defibrillator coil to existing pacing leads, extraction/replacement of pacing system, or a sternotomy/epicardial ICD placement. The procedure was accomplished uneventfully with successful defibrillation threshold testing. Innovative approaches are required to manage arrhythmias in adults with CHD, with shared decision making playing a critical role.
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Affiliation(s)
- Soham Dasgupta
- Division of Pediatric Cardiology, Department of Pediatrics, Norton Children's Hospital, University of Louisville, USA.
| | - Kevin Thomas
- Division of Cardiology, Department of Internal Medicine, Norton Hospital, USA
| | - Christopher Johnsrude
- Division of Pediatric Cardiology, Department of Pediatrics, Norton Children's Hospital, University of Louisville, USA
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3
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Römers H, Liebregts M, van Dijk V, Boersma L. The substernal implantable cardioverter-defibrillator: First experience combining an extravascular-implantable cardioverter-defibrillator with a dual-chamber transvenous pacemaker. HeartRhythm Case Rep 2024; 10:132-136. [PMID: 38404971 PMCID: PMC10885689 DOI: 10.1016/j.hrcr.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Affiliation(s)
- Hans Römers
- Department of Cardiology, Sint Antonius Hospital, Nieuwegein, The Netherlands
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Max Liebregts
- Department of Cardiology, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Vincent van Dijk
- Department of Cardiology, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Lucas Boersma
- Department of Cardiology, Sint Antonius Hospital, Nieuwegein, The Netherlands
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Rubinstein M, Zhu A, Mariani JA, Patel HC. Subcutaneous defibrillator use with unipolar pacemakers: Cautiously possible. Indian Pacing Electrophysiol J 2023; 23:126-129. [PMID: 37196770 PMCID: PMC10323176 DOI: 10.1016/j.ipej.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/05/2023] [Accepted: 05/14/2023] [Indexed: 05/19/2023] Open
Abstract
Implantation of subcutaneous implantable cardioverter-defibrillator in a patient with existing unipolar pacemaker is against manufacturer recommendations. We report the case of a successful subcutaneous implantable cardioverter-defibrillator implantation in a patient with Fontan circulation and concomitant active unipolar pacing and present a summary of recommendations when considering subcutaneous implantable cardioverter-defibrillator implantation with unipolar pacing. Recommendations included: pre-procedure screening, rescreening during implantation and ventricular fibrillation induction, pacemaker programming, and post-procedure investigations.
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Affiliation(s)
| | - Angela Zhu
- Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia
| | - Justin A Mariani
- Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia; Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Central Clinical School, Monash University, Melbourne, Australia
| | - Hitesh C Patel
- Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia; Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Central Clinical School, Monash University, Melbourne, Australia.
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Russo V, Ciabatti M, Brunacci M, Dendramis G, Santobuono V, Tola G, Picciolo G, Teresa LM, D'Andrea A, Nesti M. Opportunities and drawbacks of the subcutaneous defibrillator across different clinical settings. Expert Rev Cardiovasc Ther 2023; 21:151-164. [PMID: 36847583 DOI: 10.1080/14779072.2023.2184350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an established therapy for the prevention of sudden cardiac death (SCD) and an alternative to a transvenous implantable cardioverter-defibrillator system in selected patients. Beyond randomized clinical trials, many observational studies have described the clinical performance of S-ICD across different subgroups of patients. AREAS COVERED Our review aimed to describe the opportunities and drawbacks of the S-ICD, focusing on their use in special populations and across different clinical settings. EXPERT OPINION The choice to implant S-ICD should be based on the patient's tailored approach, which takes into account the adequate S-ICD screening at rest or during stress, the infective risk, the ventricular arrhythmia susceptibility, the progressive nature of the underlying disease, the work or sports activity, and the risk of lead-related complications.
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Affiliation(s)
- Vincenzo Russo
- Cardiology Unit, University of Campania 'Luigi Vanvitelli' - Monaldi Hospital, Naples, Italy
| | | | | | | | | | | | | | | | | | - Martina Nesti
- Cardiology Unit, San Donato Hospital, Arezzo (FI), Italy
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Nieves J, Laslett DB, Basil A, Whitman IR, Cooper JM, Cronin EM. Simultaneous Leadless Pacemaker and Subcutaneous ICD Implantation With Intraoperative Screening: Workflow in Two Patients. JACC Case Rep 2022; 4:101535. [PMID: 36507298 PMCID: PMC9730143 DOI: 10.1016/j.jaccas.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/09/2022] [Accepted: 06/06/2022] [Indexed: 11/06/2022]
Abstract
A communicating subcutaneous implantable cardioverter-defibrillator (ICD) and leadless pacemaker system is being developed for patients who require both pacing and ICD therapy. It is important to ensure that the paced morphology from the leadless pacemaker will be sensed appropriately by the subcutaneous ICD. We present 2 cases illustrating our approach and workflow. (Level of Difficulty: Intermediate.).
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Affiliation(s)
| | | | | | | | | | - Edmond M. Cronin
- Address for correspondence: Dr Edmond M. Cronin, Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, 9th Floor, Parkinson Pavilion, Philadelphia, Pennsylvania 19140, USA.
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7
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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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Ishii N, Nakajima K, Kakuta T, Noda T, Fujita T, Kusano K. One Indication for an Extravascular Cardiac Resynchronization Therapy Defibrillator: Lessons from a Combination Therapy Case with Epicardial Cardiac Resynchronization Therapy and a Subcutaneous Implantable Cardioverter Defibrillator. Intern Med 2021; 60:1877-1880. [PMID: 33518564 PMCID: PMC8263187 DOI: 10.2169/internalmedicine.6125-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Extravascular cardiac resynchronization therapy (CRT) defibrillators (CRT-Ds) are ideal for recurrent blood stream infections. Furthermore, CRT is useful for patients intolerant to right ventricular (RV) pacing. The case was a 65-year-old man with a CRT-D who presented with a blood stream infection. Because he was hemodynamically unstable with temporary RV pacing, an epicardial CRT device was re-implanted concomitantly through a surgical procedure. After the operation, a subcutaneous implantable cardioverter defibrillator (S-ICD) was placed. However, not all pacing is eligible for S-ICD screening. Combination therapy with an epicardial CRT device and S-ICD might be an alternate option for cardiac surgery cases.
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Affiliation(s)
- Natsuko Ishii
- Department of Cardiovascular internal medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular internal medicine, National Cerebral and Cardiovascular Center, Japan
- Graduate School of Medical Sciences Kumamoto University, Japan
| | - Takashi Kakuta
- Department of Cardiovascular surgery, National Cerebral and Cardiovascular Center, Japan
| | - Takashi Noda
- Department of Cardiovascular internal medicine, National Cerebral and Cardiovascular Center, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular surgery, National Cerebral and Cardiovascular Center, Japan
| | - Kengo Kusano
- Department of Cardiovascular internal medicine, National Cerebral and Cardiovascular Center, Japan
- Graduate School of Medical Sciences Kumamoto University, Japan
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Zhang Y, Dai WL, Lin CC, Li QY, Guo CJ. Implantation of an S-ICD in a Patient with a DDD Pacemaker and Congenitally Corrected Transposition of the Great Arteries. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2021. [DOI: 10.15212/cvia.2019.0597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Subcutaneous implantable cardioverter-defibrillator (S-ICD) therapy has become a viable alternative to conventional transvenous ICD implantation. Patients with congenitally corrected transposition of the great arteries (ccTGA) have a high risk of sudden cardiac death due to malignant
arrhythmia. The interaction between the S-ICD system and the transvenous pacemaker system is not fully understood. We report a case of S-ICD implantation in a patient with ccTGA and a DDD pacemaker. The patient was a 30-year-old man with a previously placed pacemaker with diagnoses of congenital
heart disease, ccTGA (SLL), left atrioventricular valve insufficiency, and third-degree atrioventricular block. He presented with an out-of-hospital cardiac arrest, and an S-ICD was implanted to prevent sudden cardiac death. Defibrillation checks were performed successfully. We tested the
compatibility of the DDD pacemaker with the S-ICD and found that there was no interference between them. In conclusion, an S-ICD system is a reasonable and safe option in patients with ccTGA.
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Affiliation(s)
- Yu Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wen-Long Dai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Can-Can Lin
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qiao-Yuan Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Cheng-Jun Guo
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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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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11
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Bögeholz N, Willy K, Niehues P, Rath B, Dechering DG, Frommeyer G, Kochhäuser S, Löher A, Köbe J, Reinke F, Eckardt L. Spotlight on S-ICD™ therapy: 10 years of clinical experience and innovation. Europace 2019; 21:1001-1012. [DOI: 10.1093/europace/euz029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/09/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Subcutaneous ICD (S-ICD™) therapy has been established in initial clinical trials and current international guideline recommendations for patients without demand for pacing, cardiac resynchronization, or antitachycardia pacing. The promising experience in ‘ideal’ S-ICD™ candidates increasingly encourages physicians to provide the benefits of S-ICD™ therapy to patients in clinical constellations beyond ‘classical’ indications of S-ICD™ therapy, which has led to a broadening of S-ICD™ indications in many centres. However, the decision for S-ICD™ implantation is still not covered by controlled randomized trials but rather relies on patient series or observational studies. Thus, this review intends to give a contemporary update on available empirical evidence data and technical advancements of S-ICD™ technology and sheds a spotlight on S-ICD™ therapy in recently discovered fields of indication beyond ideal preconditions. We discuss the eligibility for S-ICD™ therapy in Brugada syndrome as an example for an adverse and dynamic electrocardiographic pattern that challenges the S-ICD™ sensing and detection algorithms. Besides, the S-ICD™ performance and defibrillation efficacy in conditions of adverse structural remodelling as exemplified for hypertrophic cardiomyopathy is discussed. In addition, we review recent data on potential device interactions between S-ICD™ systems and other implantable cardio-active systems (e.g. pacemakers) including specific recommendations, how these could be prevented. Finally, we evaluate limitations of S-ICD™ therapy in adverse patient constitutions, like distinct obesity, and present contemporary strategies to assure proper S-ICD™ performance in these patients. Overall, the S-ICD™ performance is promising even for many patients, who may not be ‘classical’ candidates for this technology.
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Affiliation(s)
- Nils Bögeholz
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Kevin Willy
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Philipp Niehues
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Benjamin Rath
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Dirk G Dechering
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Gerrit Frommeyer
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Simon Kochhäuser
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Andreas Löher
- Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany
| | - Julia Köbe
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Florian Reinke
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Lars Eckardt
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
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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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