This report discusses the intraoperative preservation of an extravascular implantable cardioverter-defibrillator lead during coronary artery bypass grafting.
Implantable cardioverter-defibrillators (ICDs) have been a cornerstone therapy for decades to prevent sudden cardiac death in patients at risk for life-threatening ventricular arrhythmias.1 Conventional transvenous ICD (TV-ICD) systems provide reliable defibrillation but carry lead-related risks, including vascular injury at implantation, systemic infection, and tricuspid valve dysfunction related to endovascular hardware.2,3 The extravascular ICD (EV-ICD) has recently emerged as a non-intravascular, lead-based system that delivers defibrillation via a substernal lead, thereby avoiding the bloodstream while expanding device options for selected patients.
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Mansouri et al. (2026) studied this question.
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