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Updated: Jul 11, 2026
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Contemporary issues in implantable cardioverter-defibrillators: Personalising device therapy
Christopher Monkhouse1, Syed Ahsan2, Pier D Lambiase3
1Barts Heart Centre, West Smithfield, London, UK; William Harvey Research Institute, Queen Mary University of London (QMUL), London, UK.
Indian Heart Journal
|October 19, 2025
Summary
Implantable Cardioverter Defibrillators (ICDs) have evolved to reduce sudden cardiac death. Newer subcutaneous and extravascular ICDs offer alternatives to traditional transvenous systems, with modular therapies promising comprehensive, individualized solutions.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Implantable Cardioverter Defibrillators (ICDs) have evolved since the 1980s to prevent sudden cardiac death.
- Traditional transvenous ICDs (TV-ICDs) carry risks associated with intracardiac leads.
- Subcutaneous ICDs (S-ICDs) mitigate lead-related complications but lack pacing capabilities.
Purpose of the Study:
- To review the evolution and current state of ICD technologies.
- To compare the strengths and limitations of TV-ICDs, S-ICDs, and extravascular ICDs (EV-ICDs).
- To discuss emerging modular ICD therapies and future directions in personalized ICD treatment.
Main Methods:
- Literature review of available data up to 2025.
- Critical appraisal of current evidence in ICD studies.
- Analysis of technological advancements and clinical outcomes.
Main Results:
- S-ICDs reduce acute and long-term complications compared to TV-ICDs for patients without pacing needs.
- EV-ICDs present a potential solution with substernal lead placement, requiring further investigation.
- Modular ICD systems combining S-ICD with leadless pacemakers offer advanced pacing capabilities.
Conclusions:
- ICD technology selection should balance risks and benefits, considering patient-specific needs.
- Informed patient consent regarding ICD risks and benefits is crucial.
- Future ICD therapy will likely be highly customizable, leveraging advanced capabilities and remote monitoring.
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