Related Experiment Videos
[New approach for implantation of automatic defibrillators using videothoracoscopy]
J F Obadia1, J J Lehot, F Thévenet
1Service de Chirurgie Cardio-Thoracique, Hospices Civils, Lyon.
Annales De Cardiologie Et D'Angeiologie
|September 1, 1994
Summary
Video-assisted thoracoscopy offers a minimally invasive approach for extrapericardial patch insertion in implantable cardioverter defibrillator (ICD) patients. This technique effectively reduces high defibrillation thresholds (DTs) when standard systems fail.
Area of Science:
- Cardiology
- Minimally Invasive Surgery
- Medical Devices
Context:
- Nonthoracotomy lead systems are common for implantable cardioverter defibrillators (ICDs).
- Some patients experience high defibrillation thresholds (DTs) requiring invasive procedures.
- Epicardial patches are an alternative when endocardial leads are insufficient.
Purpose:
- To evaluate the efficacy of extrapericardial patch insertion using video-thoracoscopy in patients with ICDs and high DTs.
- To assess the safety and effectiveness of this minimally invasive technique.
Summary:
- Three patients with high DTs (>20 J) following endocardial lead systems underwent extrapericardial patch insertion via thoracoscopy.
- The procedure involved a subcostal incision and thoracoscopic placement and suturing of the patch.
- Postoperative DTs were significantly reduced (10-20 J), and recovery was uneventful.
- Thoracoscopy also enabled complementary procedures like stellectomy for conditions such as long QT syndrome.
Impact:
- This approach may reduce the need for thoracotomy in ICD patients with persistent high DTs.
- It offers a less invasive option for optimizing defibrillation efficacy.
- Further research is needed to compare this technique with other lead configurations.