Objective To report our initial experience of transveneous pectoral implantation of single lead implantable cardioverter defibrillator (ICD) in fifteen patients. Methods Fifteen patients (male 13, female 2, mean ag...Objective To report our initial experience of transveneous pectoral implantation of single lead implantable cardioverter defibrillator (ICD) in fifteen patients. Methods Fifteen patients (male 13, female 2, mean age of 51.7 years), including dilated cardiomyopathy in 4, hypertrophic cardiomyopathy in 2, coronary artery disease in 5 and syncope of unknown etiology in 2, underwent ICD implantation. Indications for ICD implantation were ventricular fibrillation (8 patients) and refractory ventricular tachycardia (7 patients). All patients had syncope out of hospital. The ICD system were Medtronic Jewel active can in 5 patients (Model 7219C in 2, 7220C in 3) and CPI Ventak PRxⅢ in 9 patients. For active can, shocks were delivered through distal coil to ICD shell and for PRxⅢ through the endotak lead of proximal to distal coil. Successful implantation criteria was 2 consecutive defibrillation at less than 24 J. Results All 15 patients had successful implantation using single lead ICD system in catheter laboratory. The mean defibrillation threshold was 12.8 J (5-15 J) and R wave was 9.9 mV (3.7-14.6 mV). All devices were of pectoral implantation. No operative and perioperative complications occurred. In 7.6 months (1-18 months) of follow up, 3 patients had VT terminated by antitachycardia pacing (ATP) and 1 patient VF terminated by shock. Conclusion Transveneous pectoral implantation of single lead ICD is easy to perform and has high defibrillation efficacy and should be a preferred approach.展开更多
文摘Objective To report our initial experience of transveneous pectoral implantation of single lead implantable cardioverter defibrillator (ICD) in fifteen patients. Methods Fifteen patients (male 13, female 2, mean age of 51.7 years), including dilated cardiomyopathy in 4, hypertrophic cardiomyopathy in 2, coronary artery disease in 5 and syncope of unknown etiology in 2, underwent ICD implantation. Indications for ICD implantation were ventricular fibrillation (8 patients) and refractory ventricular tachycardia (7 patients). All patients had syncope out of hospital. The ICD system were Medtronic Jewel active can in 5 patients (Model 7219C in 2, 7220C in 3) and CPI Ventak PRxⅢ in 9 patients. For active can, shocks were delivered through distal coil to ICD shell and for PRxⅢ through the endotak lead of proximal to distal coil. Successful implantation criteria was 2 consecutive defibrillation at less than 24 J. Results All 15 patients had successful implantation using single lead ICD system in catheter laboratory. The mean defibrillation threshold was 12.8 J (5-15 J) and R wave was 9.9 mV (3.7-14.6 mV). All devices were of pectoral implantation. No operative and perioperative complications occurred. In 7.6 months (1-18 months) of follow up, 3 patients had VT terminated by antitachycardia pacing (ATP) and 1 patient VF terminated by shock. Conclusion Transveneous pectoral implantation of single lead ICD is easy to perform and has high defibrillation efficacy and should be a preferred approach.
