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A subcutaneous lead array for implantable cardioverter defibrillators

L Jordaens¹, P Vertongen, Y van Belleghem

¹Department of Cardiology, University Hospital, Ghent, Belgium.

Pacing and Clinical Electrophysiology : PACE

|July 1, 1993

Summary

A novel subcutaneous lead array combined with implantable cardioverter defibrillators offers improved defibrillation thresholds. This approach is beneficial when transvenous leads alone are insufficient or when subcutaneous patches cause issues.

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Area of Science:

Cardiology
Biomedical Engineering

Background:

Implantable cardioverter defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
Achieving low defibrillation thresholds (DFT) is essential for ICD efficacy.
Transvenous leads and subcutaneous patches have limitations in achieving optimal DFTs.

Purpose of the Study:

To evaluate the efficacy of a novel three-branched subcutaneous lead array in combination with ICD therapy.
To assess if this new approach can achieve lower DFTs compared to conventional methods.

Main Methods:

The study involved implanting ICDs with a combination of transvenous and subcutaneous lead arrays in two patients.
A third patient received the subcutaneous array to replace a malfunctioning subcutaneous patch.
Defibrillation thresholds were measured in all patients.

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Main Results:

Low DFTs (< or = 10 J and < or = 15 J) were achieved in the first two patients, which were not attainable with transvenous leads alone.
The subcutaneous array in the third patient resulted in a DFT of < or = 20 J, significantly lower than the > 24 J with the previous patch.
No surgical complications were reported.

Conclusions:

The subcutaneous lead array represents a technical advancement in ICD therapy.
This approach is advantageous when standard transvenous systems fail to provide adequate defibrillation safety margins.
It offers a viable alternative in cases of surgical or postsurgical complications with subcutaneous patches.