Novel Extravascular Defibrillation Configuration With a Coil in the Substernal Space: The ASD Clinical Study

JACC. Clinical Electrophysiology
Joseph Y S ChanMark C S Hall

Abstract

This study assessed the defibrillation efficacy of the substernal-lateral electrode configuration. Subcutaneous implantable cardioverter-defibrillators (ICDs) are regarded as alternatives to transvenous ICDs in certain subjects. However, substantially higher shock energy of up to 80 J may be required. Proposed is a new defibrillation method of placing the shock coil into the substernal space. This prospective, nonrandomized, feasibility study was conducted in subjects scheduled for midline sternotomy or implant of ICD. A blunted end tunneling tool was used to insert a defibrillation lead behind the sternum using a percutaneous subxiphoid approach. A skin patch electrode was placed on the left mid-axillary line at the fourth to fifth intercostal space. After ventricular fibrillation induction, a single 35-J shock was delivered between the lead and skin patch. Sixteen subjects (12 males, 4 females; mean age: 61.6 ± 11.8 years) were enrolled. The mean lead placement time was 11.1 ± 6.6 min. Of the 14 subjects with successfully induced ventricular fibrillation episodes, 13 subjects (92.9%) had successful defibrillation. The 1 failure was associated with high and lateral shock coil placement. Mean ventricular fibrillation duration w...Continue Reading

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Citations

Aug 15, 2020·Clinical Cardiology·Christoph SchukroCesar Khazen
Mar 2, 2018·Pacing and Clinical Electrophysiology : PACE·Andrea DroghettiMassimiliano Marini
Aug 15, 2018·Der Internist·C StellbrinkD Meyer Zu Vilsendorf
Mar 20, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Nils BögeholzLars Eckardt
Mar 3, 2021·Cardiovascular Drugs and Therapy·Khurrum KhanMihail G Chelu
Feb 20, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Perin KothariAdam Dalia
Jul 30, 2021·Journal of Cardiovascular Electrophysiology·Ian CrozierPaul Friedman
Aug 29, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Johanna B Tonko, Christopher A Rinaldi
Nov 10, 2021·Herz·Vincent F van Dijk, Lucas V A Boersma

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