Key result
An anteroposterior subcutaneous ICD configuration with 160 μF capacitance, 1,000 V, and 70 J output achieved a 93% success rate for defibrillation safety margin testing.
Why the study?
Do specific combinations of anteroposterior subcutaneous shock pathways and waveforms improve defibrillation efficacy in patients temporarily implanted with subcutaneous coil electrodes?
Population
141 patients temporarily implanted with an active can emulator and subcutaneous coil electrodes
Comparison
Subcutaneous ICD configurations with varying can… vs Different subcutaneous ICD configurations…
Design
Cohort
Authors
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Supports feasibility of anteroposterior subcutaneous testing in temporary implants; hypothesis-generating for S-ICD optimization without randomized confirmation.
Do specific combinations of anteroposterior subcutaneous shock pathways and waveforms improve defibrillation efficacy in patients temporarily implanted with subcutaneous coil electrodes?
Absolute Event Rate: 93% vs 74%
An anteroposterior subcutaneous ICD configuration with 160 μF capacitance, 1,000 V, and 70 J output achieves high defibrillation efficacy, and an infraclavicular pocket is feasible with an added parasternal coil.
Kuschyk et al. (2013) studied this question. Anteroposterior subcutaneous ICD configurations and waveforms (IM-1-1000, IC-2-1000) vs. Alternative subcutaneous configurations (IM-1-750, IC-1-750, IC-2-750) was evaluated on Defibrillation safety margin test of 2 consecutive successes at ≤50 J. An anteroposterior subcutaneous ICD configuration with 160 μF capacitance, 1,000 V, and 70 J output achieved a 93% success rate for defibrillation safety margin testing.
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