Key result
An extravascular implantable cardioverter-defibrillator was successfully combined with an epicardial pacemaker to provide defibrillation and pacing while avoiding transvenous implantation.
Why the study?
EV-ICDs have limited pacing capabilities, making transvenous devices preferable for patients needing permanent stimulation; however, alternatives are needed when transvenous implantation is not feasible.
Can an EV-ICD be combined with an epicardial pacemaker to provide defibrillation and pacing in patients where transvenous implantation is not feasible?
Case Report (n=1)
Can an EV-ICD be combined with an epicardial pacemaker to provide defibrillation and pacing in patients where transvenous implantation is not feasible?
Combining an EV-ICD with an epicardial pacemaker is a feasible alternative for patients needing both defibrillation and pacing when transvenous access is contraindicated.
The EV-ICD is a novel defibrillator with its lead placed substernally in the anterior mediastinum. Due to limited pacing capabilities, patients requiring permanent stimulation are typically better suited for a transvenous defibrillator. However, in cases where this is not feasible (such as ongoing systemic infection) alternatives must be considered. We present a case where an EV-ICD was combined with an epicardial pacemaker to provide both defibrillation and pacing, while avoiding transvenous implantation.
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Graup et al. (2025) conducted a case report in Need for defibrillation and pacing with contraindication to transvenous implantation (n=1). Extravascular implantable cardioverter-defibrillator (EV-ICD) combined with an epicardial pacemaker was evaluated. An extravascular implantable cardioverter-defibrillator was successfully combined with an epicardial pacemaker to provide defibrillation and pacing while avoiding transvenous implantation.
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