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Genetic variations accumulating within populations over generations give rise to biological evolution. Evolutionary changes can result in the formation of novel varieties and entire new species. These changes are responsible for the diverse forms of life inhabiting the planet. The evidence for evolution suggests that all living organisms descended from common ancestors.
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Molecular Evolution of the Tre Recombinase
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Evolution of extravascular implantable defibrillator technologies.

Anna Pfenniger1, Bradley P Knight1

  • 1Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America.

Progress in Cardiovascular Diseases
|April 21, 2019
PubMed
Summary

The subcutaneous ICD (S-ICD) offers a lead-free alternative for treating ventricular arrhythmias, demonstrating safety and efficacy. Future developments aim to overcome limitations like pacing capabilities and device size.

Keywords:
Modular cardiac rhythm management systemS-ICDSubcutaneous implantable cardioverter-defibrillatorSubsternal leadVentricular arrhythmias

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Implantable cardioverter-defibrillators (ICDs) effectively treat lethal ventricular arrhythmias.
  • Transvenous leads are associated with significant acute and chronic complications.
  • Extravascular ICD technology, specifically the subcutaneous ICD (S-ICD), has emerged as an alternative.

Purpose of the Study:

  • To review the current knowledge on extravascular ICD technologies.
  • To discuss the safety and efficacy of the S-ICD system.
  • To explore potential future developments in extravascular ICDs.

Main Methods:

  • Literature review of studies on extravascular ICDs.
  • Analysis of clinical data on S-ICD safety and efficacy.
  • Discussion of technological advancements and limitations.

Main Results:

  • The S-ICD has been clinically available for seven years, with accumulating real-world data confirming its safety and efficacy.
  • Key limitations of S-ICD include the absence of pacing capabilities (bradycardia, tachycardia, CRT) and larger device size.
  • High energy requirements for effective defibrillation remain a consideration.

Conclusions:

  • The S-ICD represents a significant advancement in arrhythmia management, offering a leadless solution.
  • Addressing current limitations is crucial for broader S-ICD adoption and expanded therapeutic applications.
  • Ongoing research and development are focused on enhancing extravascular ICD technology.