Long-term performance of submammary defibrillator system

Area of Science:

• Cardiology
• Medical Devices
• Surgical Techniques

Background:

• Minimizing cosmetic impact of implantable cardioverter defibrillator (ICD) implantation is crucial, especially in young females.
• Submammary implantation is one technique explored for improved aesthetics.
• Limited long-term data exist for submammary ICD implantation.

Purpose of the Study:

• To report the long-term performance and safety of submammary ICD systems in young females.
• To evaluate lead performance, sensing, and defibrillation thresholds over time.
• To assess the feasibility of submammary ICD implantation for cosmetic reasons.

Main Methods:

• Retrospective data collection from August 1994 to September 2009 at two Australian institutes.
• Analysis of 20 submammary ICD implantations in young females (mean age 21 years).
• Evaluation of system performance including lead dislodgements, revisions, appropriate/inappropriate therapies, sensing, pacing thresholds, and high-voltage lead impedance.

Main Results:

• Mean follow-up of 60 months with no deaths.
• Two early lead dislodgements and three late lead revisions; no extractions.
• Stable sensing and high-voltage lead performance observed.
• Clinically insignificant rise in pacing threshold and decrease in pacing impedance noted.

Conclusions:

• Submammary ICD implantation is a feasible and safe procedure in young females.
• Long-term follow-up confirms stable sensing and high-voltage lead performance.
• This technique offers a viable option for patients concerned about cosmetic outcomes.