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      The Subcutaneous Implantable Cardioverter-Defibrillator: A Practical Review and Real-World Use and Application

      , MD, FACC, FHRS , 1,2 , , MD, FACC, FHRS 2

      Cardiovascular Innovations and Applications

      Compuscript

      subcutaneous implantable cardioverter-defibrillator, sudden cardiac death

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          Abstract

          The subcutaneous implantable cardioverter-defibrillator (ICD) is a novel technology using a subcutaneous (extrathoracic) system for treatment of potential lethal ventricular arrhythmias. It avoids many of the risks of transvenous ICD implantation. It may be considered in patients having an ICD indication who do not have a pacing and/or cardiac resynchronization therapy indication, and who are unlikely to benefit from antitachycardia pacing therapy. We review patient selection, system components, the implantation technique, and screening considerations for subcutaneous ICD implantation. Its uses in specific patient populations, including children, patients with congenital heart disease, hypertrophic cardiomyopathy, or end-stage renal disease, and patients with preexisting pacemakers, are highlighted. Areas of future investigation are reviewed, including potential use with leadless pacing and magnetic resonance imaging.

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          Most cited references 57

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          Subcutaneous implantable cardioverter defibrillator for dialysis patients: a strategy to reduce central vein stenoses and infections.

          Central venous stenosis is a common complication of the transvenous leads associated with an implantable cardioverter defibrillator (ICD). Although epicardial leads have been reported to bypass this complication, their placement is much more invasive than the subcutaneous ICDs (SICDs) and requires the services of a cardiothoracic surgeon. Recent data have demonstrated successful defibrillation using an SICD. In this report, we present 4 long-term hemodialysis patients treated successfully with an SICD. 3 patients received the device for primary prevention of sudden cardiac death (cardiomyopathy with low ejection fraction). The patient in the fourth case had a prolonged QT interval and received the device for secondary prevention. 3 patients had an arteriovenous fistula, whereas 1 patient was dialyzing with a tunneled dialysis catheter. Insertion of an SICD is a minimally invasive procedure. By virtue of leaving the venous system untouched, this approach might offer the advantage of reduced risk of central venous stenosis and infection over an endocardial ICD with transvenous leads. SICD is not experimental; it has been approved by the US Food and Drug Administration and is currently being used in the United States and Europe.
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            Subcutaneous implantable cardioverter-defibrillator: First single-center experience with other cardiac implantable electronic devices.

            The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an implantable device for antiarrhythmic therapy with no intravascular leads.
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              • Article: not found

              Potential eligibility of congenital heart disease patients for subcutaneous implantable cardioverter-defibrillator based on surface electrocardiogram mapping

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                Author and article information

                Journal
                CVIA
                Cardiovascular Innovations and Applications
                CVIA
                Compuscript (Ireland )
                2009-8618
                2009-8618
                February 2016
                February 2016
                : 1
                : 2
                : 199-209
                Affiliations
                1Division of Cardiology, Department of Medicine, North Florida/South Georgia Veterans Affairs Hospital, Gainesville, FL, USA
                2Section of Electrophysiology, Division of Cardiology, Department of Medicine, University of Florida, FL, USA
                Author notes
                Correspondence: Mark E. Panna Jr, MD, FACC, FHRS, Division of Cardiology, Department of Medicine, University of Florida,1600 SW Archer Road, PO Box 100277, Gainesville, FL 32610, USA, Tel.: +1-325-2739082, E-mail: mark.panna@ 123456medicine.ufl.edu
                Article
                cvia20150018
                10.15212/CVIA.2015.0018
                Copyright © 2016 Cardiovascular Innovations and Applications

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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