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Related Experiment Video

Updated: Jul 28, 2026

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

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

Published on: February 28, 2012

Noninvasive Impedance Analysis During S-ICD Insertion Provides Justification for Defibrillation Based Testing

Andreas G Kontopidis^1,2, Mark É Czeisler³, David H Yoo^3,4

¹Boston Scientific, Marlborough, Massachusetts, USA.

Pacing and Clinical Electrophysiology : PACE

|May 13, 2025

Summary

Low voltage (LV) impedance in subcutaneous implantable cardioverter-defibrillators (S-ICDs) predictably decreases post-implant. This LV impedance measurement approximates high voltage (HV) impedance, potentially informing defibrillation threshold testing (DFT) decisions.

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

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Area of Science:

Cardiology
Biomedical Engineering
Medical Devices

Background:

Subcutaneous implantable cardioverter-defibrillator (S-ICD) insertion typically includes defibrillation threshold testing (DFT).
Transvenous ICD (T-ICD) systems do not routinely undergo DFT due to clinical concerns and reliable noninvasive predictors.
Limited data exists on low voltage (LV) impedance trends and its relation to high voltage (HV) impedance in S-ICD patients.

Purpose of the Study:

To characterize the trend of LV impedance from S-ICD connection (T0) to final intraprocedural measurement (T4).
To compare LV impedance with HV impedance during DFT or 10J testing.

Main Methods:

Analysis of S-ICD implantation data from July 2022 to March 2024.
Collection of LV impedance during implant and HV impedance during testing (65J DFT or 10J).
Paired t-tests used to evaluate impedance differences at various time points.

Main Results:

LV impedance decreased by 18.3% (p <0.001) from T0 to T4 in 53 patients.
LV impedance at T4 did not significantly differ from HV impedance in 35 patients who underwent testing (p = 0.116).

Conclusions:

LV impedance predictably declines after S-ICD implantation.
LV impedance measured 60 minutes post-implant (T4) reliably approximates HV impedance.
Further evaluation is warranted on how LV impedance influences DFT decisions.