Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

180
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
180
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

348
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
348
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

321
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
321
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

272
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
272
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

155
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
155
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

347
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
347

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The Predictive Value of Impedance for Defibrillation Success After S-ICD Implantation: A Reliable Indicator?

JACC. Clinical electrophysiology·2026
Same author

Dysregulated T Cell-Mediated Immunity Underlies Progression of Arrhythmogenic Right Ventricular Cardiomyopathy.

Circulation·2026
Same author

Convergent Hybrid Ablation Versus Catheter Ablation in Patients With Persistent Atrial Fibrillation and Heart Failure: HALT AF Study Protocol and Rationale for a Multicenter Randomized Controlled Trial.

Journal of the American Heart Association·2026
Same author

Ventricular conduction is a marker for arrhythmic risk in SCN5A-E1784K overlap sodium channel disease.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology·2026
Same author

Subcutaneous Defibrillator Implantation With or Without Defibrillation Test: The Primary Results of the Randomized PRAETORIAN-DFT Trial.

Circulation·2026
Same author

Resolution of severe dilated cardiomyopathy with significant arrhythmia burden using hydroquinidine, in addition to guideline-directed medical therapy, in a patient with a pathogenic <i>SCN5A</i> variant: a case report.

European heart journal. Case reports·2026

Related Experiment Video

Updated: Dec 12, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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

26.7K

Subcutaneous or Transvenous Defibrillator Therapy.

Reinoud E Knops1, Louise R A Olde Nordkamp1, Peter-Paul H M Delnoy1

  • 1From the Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam (R.E.K., L.R.A.O.N., L.V.A.B., T.F.B., A.-F.B.E.Q., L.S., W.S., A.W., K.C.W., J.R.G., K.M.K., M.C.B., J.G.P.T., A.A.M.W.), ERN GUARD-Heart (E.R.B., P.D.L., A.A.M.W.), and the Department of Cardiology, OLVG (J.S.S.G.J.), Amsterdam, the Department of Cardiology, Isala Heart Centre, Zwolle (P.-P.H.M.D.), the Department of Cardiology, St. Antonius Hospital, Nieuwegein (L.V.A.B.), the Department of Cardiology, Flevoziekenhuis, Almere (N.R.B.), the Department of Cardiology, Radboud University Medical Center, Nijmegen (M.A.B.), the Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht (K.V.), the Department of Cardiology, Amphia Hospital, Breda (M.A.), Werkgroep Cardiologische Centra Nederland, Utrecht (M.A.), and the Department of Electrophysiology, Catharina Hospital, Eindhoven (F.A.L.E.B.) - all in the Netherlands; the First Department of Medicine-Cardiology, University Medical Center Mannheim, and the German Center for Cardiovascular Research Partner Site Heidelberg-Mannheim, Mannheim (J.K.), Klinik für Innere Medizin III, Schwerpunkt Kardiologie und Angiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel (H.B.), the Department of Medicine I, Ludwig-Maximilians University Hospital, and the German Center for Cardiovascular Research, Munich Heart Alliance, Munich (S.K.), and the Department of Electrophysiology, Heart Center at University of Leipzig, Leipzig (S.R.) - all in Germany; the Division of Cardiology Section of Electrophysiology, Emory University, Atlanta (M.F.E.-C.); the Cardiology Clinical Academic Group, St. George's, University of London and St. George's University Hospitals NHS Foundation Trust London (E.R.B.), and Office of the Director of Clinical Electrophysiology Research and Lead for Inherited Arrhythmia Specialist Services, University College London and Barts Heart Centre (P.D.L.), London, the Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford (T.R.B.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - all in the United Kingdom; Valley Health System, Ridgewood, NJ (S.M.); the Department of Cardiology, Homolka Hospital, Prague, Czech Republic (P.N.); and CorVita Science Foundation, Chicago (M.C.B.).

The New England Journal of Medicine
|August 7, 2020
PubMed
Summary

The subcutaneous implantable cardioverter-defibrillator (ICD) is noninferior to the transvenous ICD for patients needing defibrillation without pacing. This study found similar rates of complications and inappropriate shocks between the two ICD systems.

More Related Videos

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
09:47

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

Published on: April 26, 2015

16.2K
A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts
07:56

A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts

Published on: February 17, 2023

1.2K

Related Experiment Videos

Last Updated: Dec 12, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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

26.7K
A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
09:47

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

Published on: April 26, 2015

16.2K
A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts
07:56

A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts

Published on: February 17, 2023

1.2K

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Trials

Background:

  • Subcutaneous implantable cardioverter-defibrillators (ICDs) were developed to mitigate transvenous lead complications.
  • Previous comparative evidence relied mainly on observational studies.

Purpose of the Study:

  • To evaluate the noninferiority of subcutaneous ICDs compared to transvenous ICDs.
  • To assess device-related complications and inappropriate shocks as primary endpoints.
  • To explore superiority and secondary endpoints including mortality and appropriate shocks.

Main Methods:

  • A noninferiority randomized controlled trial (PRAETORIAN) was conducted.
  • Patients with ICD indication but no pacing need were assigned to subcutaneous ICD or transvenous ICD.
  • The primary endpoint was a composite of device-related complications and inappropriate shocks, with a noninferiority margin of 1.45 for the hazard ratio.

Main Results:

  • 849 patients were analyzed (426 subcutaneous ICD, 423 transvenous ICD) with a median follow-up of 49.1 months.
  • The subcutaneous ICD was noninferior to the transvenous ICD for the primary endpoint (HR 0.99, 95% CI 0.71-1.39, P=0.01).
  • Device-related complications were lower in the subcutaneous ICD group (HR 0.69), while inappropriate shocks were higher (HR 1.43).

Conclusions:

  • The subcutaneous ICD demonstrated noninferiority to the transvenous ICD in patients without a pacing indication.
  • The study met its primary noninferiority endpoint regarding device-related complications and inappropriate shocks.
  • While not statistically superior, the subcutaneous ICD offers an alternative with a different risk profile for complications.