Usefulness of lead repositioning from left to right sternal border for a patient with subcutaneous implantable cardioverter defibrillator showing high defibrillation threshold

Journal of Arrhythmia
Yasushi WakabayashiShin-Ichi Momomura

Abstract

A 62-year-old man with Brugada syndrome underwent subcutaneous implantable cardioverter defibrillator implantation. The lead was positioned along the left sternal border and defibrillation threshold (DFT) testing was performed. However, ventricular fibrillation (VF) was not terminated with 65 J and 80 J shocks. Shock impedance was 82 ohms. We repositioned the lead to the right sternal border and performed DFT testing again, followed by the VF termination with a 65 J shock. Shock impedance was 59 ohms. The positional relationship among the lead, generator, and heart was changed by lead repositioning, which may have contributed to improved shock impedance and DFT.

References

May 2, 2018·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jean-Benoit le Polain de WarouxPierre Bordachar
May 16, 2018·JACC. Clinical Electrophysiology·E Kevin HeistReinoud E Knops

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