[Clinical experiences with pectoral defibrillator implantation]

Area of Science:

• Cardiology
• Biomedical Engineering

Context:

• Transvenous defibrillation systems aim for simplified implantation.
• The fourth-generation PCD 7219 D/C cardioverter-defibrillator is designed for pectoral implantation.
• Device characteristics include a weight of 132g, size of 89x64x18mm, volume of 83cm³, and surface area of 108cm².

Purpose:

• To evaluate the feasibility and outcomes of pectoral implantation of the PCD 7219 D/C cardioverter-defibrillator.
• To assess the efficacy of the
• active-can
• system in reducing defibrillation thresholds.

Summary:

• Subpectoral implantation was successful in 79% of 75 patients with ventricular tachyarrhythmias.
• Male sex, body weight, and body surface were predictors of successful pectoral implantation.
• The
• active-can
• system demonstrated significantly lower defibrillation thresholds (9.9 ± 6.5 J) compared to dual lead systems (19 ± 4.5 J).
• Lead dislodgement occurred in two patients, necessitating revision.

Impact:

• The down-sized PCD 7219 D/C facilitates pectoral implantation in a majority of patients.
• The
• active-can
• system simplifies implantation by requiring only one right ventricular lead.
• This approach leads to significantly lower defibrillation thresholds, potentially improving patient outcomes.