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Impact of Median Sternotomy on Safety and Efficacy of the Subcutaneous Implantable Cardioverter Defibrillator.
Sugrue, Alan; Ibrahim, Rand; Lu, Marvin; Bhatia, Neal K; Alkukhun, Laith; Adewumi, Joseph; Schaller, Robert D; Marchlinski, Francis E; D'Souza, Benjamin; Nazer, Babak; Tzou, Wendy; Merchant, Faisal M; Frankel, David S.
Afiliación
  • Sugrue A; Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.).
  • Ibrahim R; Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.).
  • Lu M; Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.).
  • Bhatia NK; Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.).
  • Alkukhun L; Knight Cardiovascular Institute, Oregon Health and Science University, Portland (L.A., B.N.).
  • Adewumi J; Division of Cardiovascular Medicine, Cardiac Electrophysiology Section, University of Colorado Anschutz Medical Campus, Aurora (J.A., W.T.).
  • Schaller RD; Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.).
  • Marchlinski FE; Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.).
  • D'Souza B; Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.).
  • Nazer B; Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.).
  • Tzou W; Knight Cardiovascular Institute, Oregon Health and Science University, Portland (L.A., B.N.).
  • Merchant FM; Division of Cardiovascular Medicine, Cardiac Electrophysiology Section, University of Colorado Anschutz Medical Campus, Aurora (J.A., W.T.).
  • Frankel DS; Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.).
Circ Arrhythm Electrophysiol ; 16(8): 468-474, 2023 08.
Article en En | MEDLINE | ID: mdl-37485688
BACKGROUND: Subcutaneous implantable cardioverter defibrillators (S-ICDs) are an attractive alternative to transvenous ICDs among those not requiring pacing. However, the risks of damage to the S-ICD electrode during sternotomy and adverse interactions with sternal wires remain unclear. We sought to determine the rates of damage to the S-ICD lead during sternotomy, inappropriate shocks from electrical noise due to interaction with sternal wires, and failure to terminate spontaneous or induced ventricular arrhythmias. METHODS: Retrospective, multicenter study of patients undergoing sternotomy before or after S-ICD implantation. Clinical, procedural, and device-related data were collected by each center and analyzed by the coordinating center. These data were compared with a historical control cohort of nonsternotomy patients. RESULTS: Of 196 identified patients (52±16 years, 47 women), 166 underwent S-ICD implantation after sternotomy and 30 sternotomy after S-ICD. There was no damage to any lead among those who underwent sternotomy after S-ICD. Defibrillation threshold testing was performed in 63% at implant, with 91% first shock success. During a median follow-up of 29 months (range, 1-188), S-ICD first shocks successfully terminated spontaneous ventricular arrhythmias in 31 of 32 patients (97%). Inappropriate shocks occurred in 22 patients, most commonly related to T wave oversensing (n=14). Compared with the nonsternotomy controls, there were no differences in rates of first shock success for induced or spontaneous arrhythmias or rate of inappropriate shocks. CONCLUSIONS: Sternotomy before or after S-ICD does not confer additional risk relative to a historical control group without sternotomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Desfibriladores Implantables Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Desfibriladores Implantables Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos