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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
Simultaneous Transvenous Lead Extraction and Intra-Operative Epicardial Extravascular Defibrillator (EV-ICD)
Joseph Canavan1, Piers Wright1, Gianluca Lucchese1
1Cleveland Clinic London London UK.
Clinical Case Reports
|July 3, 2026
Summary
Transvalvular device leads after tricuspid valve replacement are problematic. Simultaneous lead extraction and EV-ICD implantation offers defibrillator therapy without crossing the prosthetic valve, potentially avoiding extra pacing hardware.
Area of Science:
- Cardiovascular medicine
- Medical device technology
- Electrophysiology
Background:
- Transvalvular device leads pose risks after tricuspid valve replacement.
- Maintaining defibrillator therapy is crucial for patients with heart conditions.
Purpose of the Study:
- To evaluate the feasibility of simultaneous lead extraction and EV-ICD implantation.
- To assess an alternative to traditional transvenous lead placement in tricuspid valve replacement patients.
Main Methods:
- Simultaneous extraction of existing leads.
- Intra-operative implantation of an extravascular implantable cardioverter-defibrillator (EV-ICD).
- Assessment of device function and patient outcomes.
Main Results:
- Successful lead extraction and EV-ICD implantation achieved.
- Defibrillator therapy was provided without crossing the prosthetic valve.
- Avoidance of additional pacing hardware was possible when atrioventricular conduction was preserved.
Conclusions:
- Simultaneous lead extraction and EV-ICD implantation is a viable strategy.
- This approach offers an alternative to transvenous leads post-tricuspid valve replacement.
- It potentially improves patient management by avoiding prosthetic valve interaction.
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