The extravascular implantable cardioverter-defibrillator (EV ICD) system, evaluated in >140 human implants, offers defibrillation and pacing therapies while avoiding transvenous hardware complications.
Does the extravascular implantable cardioverter-defibrillator (EV ICD) provide effective defibrillation and pacing therapies while avoiding long-term complications of transvenous systems?
The EV ICD system with substernal lead placement is a promising novel alternative to transvenous and subcutaneous ICDs, offering defibrillation and pacing without vascular placement.
INTRODUCTION: The extravascular implantable cardioverter-defibrillato (EV ICD) system with substernal lead placement is a novel nontransvenous alternative to current commercially available ICD systems. The EV ICD provides defibrillation and pacing therapies without the potential long-term complications of endovascular lead placement but requires a new procedure for implantation with a safety profile under evaluation. METHODS: This paper summarizes the development of the EV ICD, including the preclinical and clinical evaluations that have contributed to the system and procedural refinements to date. RESULTS: Extensive preclinical research evaluations and four human clinical studies with >140 combined acute and chronic implants have enabled the development and refinement of the EV ICD system, currently in worldwide pivotal study. CONCLUSION: The EV ICD may represent a clinically valuable solution in protecting patients from sudden cardiac death while avoiding the long-term consequences of transvenous hardware. The EV ICD offers advantages over transvenous and subcutaneous systems by avoiding placement in the heart and vasculature; relative to subcutaneous systems, EV ICD requires less energy for defibrillation, enabling a smaller device, and provides pacing features such as antitachycardia and asystole pacing in a single system.
Thompson et al. (Thu,) conducted a review in Sudden cardiac arrest (n=140). Extravascular implantable cardioverter-defibrillator (EV ICD) vs. Transvenous and subcutaneous systems was evaluated. The extravascular implantable cardioverter-defibrillator (EV ICD) system, evaluated in >140 human implants, offers defibrillation and pacing therapies while avoiding transvenous hardware complications.