Related Experiment Video
Updated: Jun 22, 2026
16:40
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Transiliac ICD implantation: defibrillation vector flexibility produces consistent success
Chi Keong Ching1, Claude S Elayi, Luigi Di Biase
1Cleveland Clinic, Cleveland, Ohio 44195, USA.
Heart Rhythm
|June 30, 2009
Summary
The transiliac approach for implantable cardioverter-defibrillator (ICD) placement is a safe and effective alternative for patients unsuitable for pectoral implantation. This method allows for flexible lead positioning and defibrillation vectors, ensuring system efficacy.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Techniques
Background:
- The transiliac approach offers an alternative for implantable cardioverter-defibrillator (ICD) placement when pectoral sites are contraindicated.
- This technique alters the defibrillation vector due to abdominal pulse generator placement and specific lead positioning.
Purpose of the Study:
- To evaluate the feasibility, safety, and complication rates of the transiliac ICD implantation approach.
- To assess defibrillation testing (DFT) results using this alternative configuration.
Main Methods:
- The study involved 23 patients undergoing transiliac ICD implantation via the iliac vein.
- Leads were positioned in the high right atrium and right ventricular apex; subcutaneous coils were used when necessary.
Main Results:
- Initial defibrillation success was achieved in 15 patients, increasing to 19 with an additional coil.
- All patients achieved defibrillation success with a 5 J safety margin, with no acute complications.
- Late complications included lead malfunction, device infection, and lead fracture in 3 patients.
Conclusions:
- The iliac vein approach is a safe and effective alternative for ICD implantation.
- Successful implementation requires flexibility in lead and defibrillation vector placement, alongside careful DFT.
