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Garcia-Fernández FJ, Martín González J, Villagraz Tercedor L, Fernández Palacios G, Cantero D, Vallés E, Trucco E. Feasibility, safety, and comfort of the '2BB' (2 cm below the bra) position of insertable cardiac monitors in women: the IN-WOMEN-ICM pilot study. Europace 2024; 26:euae080. [PMID: 38569064 PMCID: PMC11017509 DOI: 10.1093/europace/euae080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- F Javier Garcia-Fernández
- Arrythmia Unit, Cardiology Department, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006 Burgos, Spain
| | - Javier Martín González
- Arrythmia Unit, Cardiology Department, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006 Burgos, Spain
| | - Lola Villagraz Tercedor
- Arrythmia Unit, Cardiology Department, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006 Burgos, Spain
| | - Gonzalo Fernández Palacios
- Arrythmia Unit, Cardiology Department, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006 Burgos, Spain
| | - Daniel Cantero
- Arrythmia Unit, Cardiology Department, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006 Burgos, Spain
| | - Ermengol Vallés
- Arrythmia Unit, Cardiology Department, Hospital del Mar, Barcelona, Universidad Pompeu Fabra, Paseo marítimo de la Barceloneta 25, 08003 Barcelona, Spain
| | - Emilce Trucco
- Arrythmia Unit, Cardiology Department, Hospital Universitario de Girona Dr Josep Trueta, Spain Avinguda de França, S/N, 17007 Girona, Spain
- Institut d’Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
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Ribeiro L, Chan-Seng E, Gil V, Sanrey E, Coubes P, Poulen G. Submammary Implantation of Internal Pulse Generators for Deep Brain Stimulation: Long-Term Follow-up of Device Acceptance and Quality of Life in Women. World Neurosurg 2022; 167:e1025-e1031. [PMID: 36058486 DOI: 10.1016/j.wneu.2022.08.126] [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] [Received: 08/19/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND A submammary approach to implanting pulse generators is innovative and has yielded good aesthetic results in the current literature. It was our aim to make a comparison of patient device acceptance, tolerance, and complications between submammary and abdominal device locations in deep brain stimulation. METHODS Twenty-five and 28 patients were included in the submammary and abdominal groups, respectively. Our primary criterion was patient acceptance that was calculated using total Florida Patient Acceptance Survey (FPAS) scores in each group. Secondarily, tolerance was assessed in the submammary group by means of a specific questionnaire. RESULTS Total FPAS scores from the submammary group [total FPAS: 77.1 versus 74.7, P = 0.29] revealed no significant difference when compared with the abdominal group. The same similarities were observed regarding the 4 subscales: return to function [16.3 versus 15.8, P = 0.53], device-related distress [22.0 versus 21.3, P = 0.31], body image concerns [9.2 versus 8.6, P = 0.14], and positive appraisal [17.8 versus 17.4, P = 0.58]. Tolerance was reported as good by the majority of the women from the submammary group. There was no evidence of higher infection rates in the submammary implantation (SMI) group. CONCLUSIONS SMI is a satisfactory alternative to other deep brain stimulation locations. SMI is a feasible option for any young woman who is eligible for deep brain stimulation.
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Affiliation(s)
- Lucas Ribeiro
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Emilie Chan-Seng
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Valérie Gil
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Emily Sanrey
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Philippe Coubes
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Gaëtan Poulen
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France.
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Goh JC, Boey E, Kojodjojo P, Vigneswaran N. Submammary placement of implantable cardioverter defibrillators: a Singapore plastic surgeon experience. Singapore Med J 2022; 63:47-50. [DOI: 10.11622/smedj.2022025] [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]
Abstract
The use of implantable cardioverter defibrillators (ICDs) in young women has been increasing in recent years owing to greater awareness about inherited cardiac conditions that increase the risk of sudden death. Traditional placement of ICDs in the infraclavicular region among young women often leads to visible scars, a constant prominence that causes irritation from purse or bra straps and can result in body image concerns and device-related emotional distress. In this case series, two women with long QT syndrome required placement of ICDs for prevention of sudden cardiac death. Submammary placement of ICDs was performed in collaboration with electrophysiologists. We describe our local experience and technique in submammary placement of ICDs as well as the challenges faced.
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Vicentini A, Bisignani G, De Vivo S, Viani S, Savarese G, Francia P, Celentano E, Checchi L, Carreras G, Santini L, Lamberti F, Ottaviano L, Scalone A, Giorgi D, Lovecchio M, Valsecchi S, Rordorf R. Patient acceptance of subcutaneous versus transvenous defibrillator systems: A multi-center experience. J Cardiovasc Electrophysiol 2021; 33:81-89. [PMID: 34797012 DOI: 10.1111/jce.15297] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an effective alternative to the transvenous ICD. No study has yet compared S-ICD and transvenous ICD by assessing patient acceptance as a patient-centered outcome. OBJECTIVE To evaluate the patient acceptance of the S-ICD and to investigate its association with clinical and implantation variables. In patients with symptomatic heart failure and reduced ejection fraction (HFrEF), the acceptance of the S-ICD was compared with a control group of patients who received a transvenous ICD. METHODS Patient acceptance was calculated with the Florida Patient Acceptance Survey (FPAS) which measures four factors: return to function (RTF), device-related distress (DRD), positive appraisal (PA), and body image concerns (BIC). The survey was administered 12 months after implantation. RESULTS 176 patients underwent S-ICD implantation. The total FPAS and the single factors did not differ according to gender, body habitus, or generator positioning. Patients with HFrEF had lower FPAS and RTF. Younger patients showed better RTF (75 [56-94] vs. 56 [50-81], p = .029). Patients who experienced device complications or device therapies showed higher DRD (40 [35-60] vs. 25 [10-50], p = .019). Patients with HFrEF receiving the S-ICD had comparable FPAS, RTF, DRD, and BIC to HFrEF patients implanted with the transvenous ICD while exhibited significantly better PA (88 [75-100] vs. 81 [63-94], p = .02). CONCLUSIONS Our analysis revealed positive patient acceptance of the S-ICD, even in groups at risk of more distress such as women or patients with thinner body habitus, and regardless of the generator positioning. Among patients receiving ICDs for HFrEF, S-ICD was associated with better PA versus transvenous ICD.
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Affiliation(s)
- Alessandro Vicentini
- Department of Arrhythmia and Electrophysiology and Experimental Cardiology, IRCCS Fondazione Policlinico 'S. Matteo', Pavia, Italy
| | | | - Stefano De Vivo
- Unità Operativa di Elettrofisiologia, 'Studio e Terapia delle Aritmie', Monaldi Hospital, Naples, Italy
| | - Stefano Viani
- Division of Second Cardiology, Department of Cardio-Thoracic and Vascular, University Hospital of Pisa, Pisa, Italy
| | - Gianluca Savarese
- Department of Cardiology, 'San Giovanni Battista' Hospital, Foligno, Italy
| | - Pietro Francia
- Cardiology, Department of Clinical and Molecular Medicine, 'St. Andrea' Hospital, Sapienza University, Rome, Italy
| | - Eduardo Celentano
- Department of Cardiology, 'Santa Maria della Pietà' Hospital, Casoria, Napoli, Italy
| | | | | | - Luca Santini
- Division of Cardiology, Divisiono of Hospital Cardiology, 'Giovan Battista Grassi' Hospital, Rome, Italy
| | - Filippo Lamberti
- Department of Medicine, Cardiovascular Section, 'San Eugenio' Hospital, Rome, Italy
| | - Luca Ottaviano
- Department of Cardiology, Istituto Clinico 'Sant'Ambrogio', Milan, Italy
| | | | - Davide Giorgi
- Division of Cardiology, 'San Luca' Hospital, Lucca, Italy
| | | | | | - Roberto Rordorf
- Department of Arrhythmia and Electrophysiology and Experimental Cardiology, IRCCS Fondazione Policlinico 'S. Matteo', Pavia, Italy
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