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Sonoda Y, Fukuzawa K, Kiuchi K, Takami M, Izawa Y, Nakamura T, Takahara H, Yamamoto K, Nakasone K, Suzuki Y, Tani K, Iwai H, Nakanishi Y, Shoda M, Murakami A, Yonehara S, Hirata KI. The relationship between the incision line and position of the latissimus dorsi muscle for subcutaneous implantable cardioverter-defibrillator intermuscular implantations. J Cardiovasc Electrophysiol 2023. [PMID: 37313805 DOI: 10.1111/jce.15967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/12/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Intermuscular implantations of subcutaneous implantable cardioverter-defibrillators (S-ICD) have been recommended, but the position of the anterior border of the latissimus dorsi muscle (LDM) has not previously been evaluated in establishing an incision line to facilitate the intermuscular approach. The objective of this study is to evalua the position and trend of the anterior border of the LDM in patients who are candidates for implantable cardioverter-defibrillators. METHODS The distance from the back to the anterior border of the LDM (A) and the anterior-posterior width of the chest wall (B) were measured on computed tomography retrospectively, and the ratio (=A/B) was used as the position of the anterior border of the LDM. In addition, the variability and factors affecting the values were evaluated. RESULTS An analysis was performed on 78 patients, and the position of the anterior border of the LDM (=A/B) exhibited a normal distribution, with a mean value of 0.53 ± 0.062 (0.41-0.69). The position of the anterior border of the LDM tended to be more anterior in younger, taller, male, primary prevention, nonheart failure, low brain natriuretic peptide level, and nondiabetic patients. CONCLUSION The position of the anterior border of the LDM varied from case to case with variable results. Conventional incisions on the midaxillary line may be inappropriate for intermuscular implantations, and the position of the anterior border of the LDM should be evaluated in each individual case to establish the incision line.
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Affiliation(s)
- Yusuke Sonoda
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Koji Fukuzawa
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
- Section of arrhythmia, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Kunihiko Kiuchi
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Mitsuru Takami
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
- Section of arrhythmia, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yu Izawa
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Toshihiro Nakamura
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Hiroyuki Takahara
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Kyoko Yamamoto
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Kazutaka Nakasone
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yuya Suzuki
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Kenichi Tani
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Hidehiro Iwai
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yusuke Nakanishi
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Mitsuhiko Shoda
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Atsushi Murakami
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Shogo Yonehara
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
- Section of arrhythmia, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
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