Extravascular implantable cardioverter-defibrillator implantation in a teenager with Brugada syndrome and recurrent inappropriate shocks of subcutaneous implantable cardioverter-defibrillator

Figures

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  Figure 1. Evidence of T-wave oversensing from subcutaneous implantable cardioverter-defibrillator interrogation. Findings from the interrogation of the subcutaneous defibrillator after the first cluster of shocks (A) and after the second one (B).

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  Figure 2. Nocturnal tachyarrhythmias recorded by the loop recorder. A: Tachogram displaying an arrhythmia with abrupt onset and termination, and an estimated heart rate of 170–180 bpm; double-sensing artifacts could be excluded. B: Electrogram of the same arrhythmia. bpm = beats per minute.

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  Figure 3. Spontaneous Brugada syndrome type 1 pattern.

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  Figure 4. Chest computed tomography scan. Axial slice (left) and sagittal reconstruction (right).

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  Figure 5. Correct R-wave detection during the intraoperative control of the extravascular device.

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  Figure 6. Chest radiography findings at discharge. Anteroposterior (left) and laterolateral view (right) showing positioning of the substernal lead.

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  Figure 7. Implantation of an extravascular defibrillator in an adolescent. ICD = implantable cardioverter-defibrillator; EV-ICD = extravascular implantable cardioverter-defibrillator; S-ICD = subcutaneous implantable cardioverter-defibrillator.