Acute human defibrillation performance of a subcutaneous implantable cardioverter-defibrillator with an additional coil electrode.


Journal

Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 25 06 2023
revised: 05 08 2023
accepted: 07 08 2023
medline: 4 12 2023
pubmed: 15 8 2023
entrez: 14 8 2023
Statut: ppublish

Résumé

The subcutaneous implantable cardioverter-defibrillator (S-ICD) delivers 80 J shocks from an 8 cm left-parasternal coil to a 59 cm The purpose of this study was to acutely assess the defibrillation efficacy of parallel and transverse configurations in patients receiving an S-ICD. Testing was performed in patients receiving a conventional S-ICD system. Success at 65 J was required before investigational testing. A second electrode was temporarily inserted from the xiphoid incision connected to the PG with an investigational Y-adapter. Phase 1 (n = 11) tested the parallel configuration. Phase 2 (n = 21) tested both parallel and transverse configurations in random order. This study enrolled 35 patients (28 males (80%); mean age 51 ± 17 years; left ventricular ejection fraction 40% ± 15%; body mass index 26 ± 4 kg/m Adding a second shock coil, particularly in the parallel configuration, significantly reduced the impedance and had a high likelihood of defibrillation success at energies ≤40 J. This may enable the development of a smaller S-ICD.

Sections du résumé

BACKGROUND BACKGROUND
The subcutaneous implantable cardioverter-defibrillator (S-ICD) delivers 80 J shocks from an 8 cm left-parasternal coil to a 59 cm
OBJECTIVE OBJECTIVE
The purpose of this study was to acutely assess the defibrillation efficacy of parallel and transverse configurations in patients receiving an S-ICD.
METHODS METHODS
Testing was performed in patients receiving a conventional S-ICD system. Success at 65 J was required before investigational testing. A second electrode was temporarily inserted from the xiphoid incision connected to the PG with an investigational Y-adapter. Phase 1 (n = 11) tested the parallel configuration. Phase 2 (n = 21) tested both parallel and transverse configurations in random order.
RESULTS RESULTS
This study enrolled 35 patients (28 males (80%); mean age 51 ± 17 years; left ventricular ejection fraction 40% ± 15%; body mass index 26 ± 4 kg/m
CONCLUSION CONCLUSIONS
Adding a second shock coil, particularly in the parallel configuration, significantly reduced the impedance and had a high likelihood of defibrillation success at energies ≤40 J. This may enable the development of a smaller S-ICD.

Identifiants

pubmed: 37579867
pii: S1547-5271(23)02578-X
doi: 10.1016/j.hrthm.2023.08.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1649-1656

Informations de copyright

Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Sing-Chien Yap (SC)

Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus Medisch Centrum, Rotterdam, The Netherlands. Electronic address: s.c.yap@erasmusmc.nl.

Erik F J Oosterwerff (EFJ)

Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.

Lucas V A Boersma (LVA)

Department of Cardiology, St Antonious Ziekenhuis, Nieuwegein, The Netherlands; Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Willeke van der Stuijt (W)

Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Anneke Lenssen (A)

Boston Scientific, Amsterdam, The Netherlands.

Stephen J Hahn (SJ)

Boston Scientific CRM, St. Paul, Minnesota.

Reinoud E Knops (RE)

Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.

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Classifications MeSH