A permanent transvenous lead system for an implantable pacemaker cardioverter-defibrillator. Nonthoracotomy approach to implantation.

14 patients (11 men, 3 women) aged 39-77 years (mean 60.0 +/- 10.1 years) with left ventricular ejection fraction ranging from 16% to 63% (mean 33.4 +/- 13.1%). 9 presented with ventricular tachycardia, 3 had ventricular fibrillation, and 2 had both.

Nonthoracotomy transvenous lead system for implantable defibrillator, including leads inserted percutaneously into the right ventricular apex, superior vena cava, and distal coronary sinus, with an optional subcutaneous patch.

Successful termination of ventricular fibrillation episodes using 18 J or less, and clinical performance/safety over follow-up.