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Related Experiment Videos

Nonthoracotomy lead system for implantable defibrillator

B P Blakeman1, H J Sullivan, A Montoya

  • 1Loyola University Medical Center, Department of Thoracic and Cardiovascular Surgery, Maywood, Ill. 60153.

The Journal of Thoracic and Cardiovascular Surgery
|December 1, 1993
PubMed
Summary

The nonthoracotomy lead system offers an alternative for automatic cardioverter-defibrillator implantation, achieving a 77% success rate in 110 patients. Predictors of failure and complications were identified.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Automatic cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
  • Traditional ICD implantation involves thoracotomy, which carries significant risks.
  • The nonthoracotomy lead system aims to provide a less invasive alternative.

Purpose of the Study:

  • To evaluate the efficacy and safety of the nonthoracotomy lead system for ICD implantation.
  • To identify predictors of implantation failure and post-operative complications.

Main Methods:

  • A prospective study of 110 patients undergoing attempted ICD implantation using the nonthoracotomy lead system over 2 years.
  • Patient demographics, indications for ICD, procedural details, and outcomes were recorded.

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  • Statistical analysis was performed to identify predictors of failure.

    • Main Results:

    • Successful implantation was achieved in 85 patients (77%).
    • High defibrillation threshold (n=23) and inability to place a right ventricular lead (n=2) were primary reasons for failure.
    • Predictors of failure included preoperative antiarrhythmic drugs and low cardiac index (≤1.8 L/m2).
    • Complications included lead dislodgement (n=8) and infection (n=1).
    • Mortality rate was 2.7% due to heart failure or transplant rejection.

    Conclusions:

    • The nonthoracotomy lead system is a viable alternative for ICD implantation in selected patients.
    • Careful patient selection and management are crucial to minimize implantation failures and complications.
    • Further research is warranted to optimize this technique.