Background
Three incisions in the chest are necessary for implantation of the entirely subcutaneous
implantable cardioverter-defibrillator (S-ICD). The superior parasternal incision
is a possible risk for infection and a potential source of discomfort. A less invasive
alternative technique of implanting the S-ICD electrode—the two-incision technique—avoids
the superior parasternal incision.
Objective
The purpose of this prospective cohort study was to evaluate the safety and efficacy
of the two-incision technique for implantation of the S-ICD.
Methods
Consecutive patients who received an S-ICD between October 2010 and December 2011
were implanted using the two-incision technique, which positions the parasternal part
of the S-ICD electrode using a standard 11Fr peel-away sheath. All patients were routinely
evaluated for at least 1 year for complications and device interrogation at the outpatient
clinic.
Results
Thirty-nine patients (46% male, mean age 44 ± 15 years) were implanted with a S-ICD
using the two-incision technique. During mean follow-up of 18 months (range 14–27
months) no dislocations were observed, and there was no need for repositioning of
either the ICD or the electrode. No serious infections occurred during follow-up except
for 2 superficial wound infections of the pocket incision site. Device function was
normal in all patients, and no inappropriate sensing occurred related to the implantation
technique.
Conclusion
The two-incision technique is a safe and efficacious alternative for S-ICD implantations
and may help to reduce complications. The two-incision technique offers physicians
a less invasive and simplified implantation procedure of the S-ICD.
Abbreviations:
DFT (defibrillation threshold), EIT (electrode insertion tool), ICD (implantable cardioverter-defibrillator), S-ICD (subcutaneous implantable cardioverter-defibrillator), VF (ventricular fibrillation)Keywords
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References
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Article info
Publication history
Published online: May 23, 2013
Identification
Copyright
© 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
