High defibrillation threshold in patients with implantable defibrillator: how effective is the subcutaneous finger lead?

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Brigitte R OsswaldMatthias Karck

Abstract

Even in the era of high output implantable cardioverter defibrillator (ICD) devices, a certain proportion of patients cannot be successfully defibrillated with 10 J safety margin. In practice, either the use of a single- or double-coil lead does not guarantee successful termination of induced ventricular fibrillation. Therefore, we investigated the effectiveness of the subcutaneous finger lead placed at the subcutaneous tissue dorsal to the left ventricle in terms of defibrillation threshold (DFT) lowering. Two thousand, eight hundred and three consecutive, unselected patients underwent first-time ICD implantation or ICD device exchange from 6/1999 through 3/2007. The mean age of the patients was 65.4 years. A total of 79.3% of the patients were male. The only implanted subcutaneous lead was the 6996 model by Medtronic Inc. One hundred and seventy-seven patients (6.3%) received a subcutaneous finger lead implantation. According to the current institutional DFT testing protocol, any failure of the two standard DFT tests in first-time ICD implantation or a failure at the single test in ICD exchange operations was the trigger for subcutaneous finger lead implantation. The proportion of subcutaneous finger lead implantations increa...Continue Reading

Citations

Apr 18, 2013·Current Treatment Options in Cardiovascular Medicine·Maria Vittoria Matassini, Jeff S Healey
Dec 3, 2014·International Journal of Cardiology·Giuseppe Mario Calvagna, Salvatore Patanè
Mar 17, 2010·Pacing and Clinical Electrophysiology : PACE·Osman FaheemChristopher A Clyne
Mar 27, 2010·The Annals of Thoracic Surgery·Thierry BovéDaniel De Wolf
Jul 7, 2016·Pacing and Clinical Electrophysiology : PACE·Takeshi KodaniTohru Masuyama
Sep 20, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Jacob Moesgaard LarsenAnna M Thøgersen

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