Key result
Implanting a high-voltage lead in the azygos vein provides a suitable shocking vector and may serve as an adjunctive approach to reduce high defibrillation thresholds during ICD placement.
Why the study?
Does implantation of a high-voltage lead in the azygos vein reduce defibrillation thresholds in patients undergoing ICD placement?
Does implantation of a high-voltage lead in the azygos vein reduce defibrillation thresholds in patients undergoing ICD placement?
Implanting a high-voltage lead in the azygos vein may serve as an effective adjunctive strategy to lower high defibrillation thresholds during ICD placement.
Answers are grounded in this paper and cite their sources.
May support azygos lead as adjunct in select high-DFT ICD cases; leaves open need for prospective validation.
High defibrillation thresholds (DFTs) occasionally are encountered during placement of implantable cardioverter defibrillators (ICDs). There are multiple strategies to lower DFTs in such patients, including reassessment of right ventricular lead position, alteration of the shock waveform, and implantation of subcutaneous arrays. This article describes a novel technique of implanting a high-voltage lead in the azygos vein. This procedure may serve as an adjunctive approach to reduce DFTs. The anatomic location of the azygos vein posterior to the heart provides a suitable shocking vector between the right ventricular electrode, a high-voltage lead placed in the azygos vein, and the ICD can.
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Cesario et al. (2004) studied High defibrillation thresholds during ICD placement. Azygos vein lead implantation was evaluated on Reduction of defibrillation thresholds. Implanting a high-voltage lead in the azygos vein provides a suitable shocking vector and may serve as an adjunctive approach to reduce high defibrillation thresholds during ICD placement.
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