Implantable cardioverter-defibrillator: another device to cover

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Surgical Innovation

Background:

• Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias unresponsive to medication.
• ICDs involve significant foreign material implantation, leading to potential complications such as device exposure and infection.

Observation:

• Three patients experienced ICD generator exposure and/or infection, necessitating alternative management strategies.
• A novel surgical technique involved creating a musculofascial pocket within the rectus abdominis muscle to provide improved coverage for the ICD generator and leads.

Findings:

• This musculofascial pocket technique successfully provided adequate coverage for the ICD in two out of the three presented patients.
• The single failure in coverage was attributed to external abdominal wall trauma, not the surgical technique itself.

Implications:

• Submuscular implantation of ICD generators may reduce the incidence of device exposure and infection in select patient populations.
• Further research and larger studies are warranted to validate the long-term efficacy and safety of this surgical approach for ICD management.