What question did this study set out to answer?

To evaluate the feasibility and safety of a novel total pectoral implantation technique for cardioverter defibrillators using an endocardial lead configuration and submuscular patch.

July 1, 1993Pacing and Clinical Electrophysiology

Total Pectoral Implantation: A New Technique for Implantation of Transvenous Defibrillator Lead Systems and Implantable Cardioverter Defibrillator

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Why the study?

Is total pectoral implantation of cardioverter defibrillators with an endocardial lead system and pectoral patch feasible and effective in achieving adequate defibrillation thresholds?

Population

16 consecutive patients undergoing implantation of cardioverter defibrillators

Design

Case_series

Follow-up

average 5 months

Authors

JCJorge CamunasMount Sinai Hospital DMDavendra MehtaMount Sinai Hospital IJIP JOHN

Discussion

Member takes

Implication

Supports pectoral ICD feasibility in small series; hypothesis-generating and requires prospective validation before practice change.

Key Points

To evaluate the feasibility and safety of a novel total pectoral implantation technique for cardioverter defibrillators using an endocardial lead configuration and submuscular patch.
Enrolled 16 consecutive patients undergoing total pectoral implantation of an endocardial lead system, submuscular pectoral patch, and pulse generator.
Introduced leads via cephalic or axillary venesection and utilized a small intercostal thoracotomy for epicardial patch placement if submuscular defibrillation thresholds were inadequate.
Evaluated procedural success (defibrillation threshold ≤ 15 J), hospital stay duration, and complications over an average 5-month follow-up.
Adequate defibrillation thresholds of ≤ 15 J were achieved in 14 of 16 patients (87.5%) with a submuscular patch, and in the remaining 2 patients (12.5%) following epicardial patch placement.
Total pectoral implantation was feasible in all 16 patients (100%), with zero device repositionings required and a mean hospital stay of 5 days.
No major local symptoms or interrogation issues were reported across an average follow-up period of 5 months.

Structured PICO

Is total pectoral implantation of cardioverter defibrillators with an endocardial lead system and pectoral patch feasible and effective in achieving adequate defibrillation thresholds?

Population

16 consecutive patients undergoing implantation of cardioverter defibrillators

Intervention

Total pectoral implantation of cardioverter defibrillators with an endocardial defibrillation lead system (right atrial-superior vena cava defibrillation spring electrode, right ventricular bipolar sensing electrode, and a pectoral patch placed submuscularly or epicardially)

Outcome

Adequate defibrillation thresholds (≤ 15 joules) and feasibility of pectoral implantationsurrogate

Total pectoral implantation of ICDs using an endocardial lead system and a submuscular or epicardial patch is a feasible technique that achieves adequate defibrillation thresholds.

Cite This Study

Camunas et al. (1993) studied this question.

synapsesocial.com/papers/6a716d65ce524a4339c4f652 https://doi.org/10.1111/j.1540-8159.1993.tb01732.x

Topics

Cardiac device therapy

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Total Pectoral Implantation: A New Technique for Implantation of Transvenous Defibrillator Lead Systems and Implantable Cardioverter Defibrillator

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Total Pectoral Implantation: A New Technique for Implantation of Transvenous Defibrillator Lead Systems and Implantable Cardioverter Defibrillator

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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