Implantable intravascular defibrillator: Defibrillation thresholds of an intravascular cardioverter-defibrillator compared with those of a conventional ICD in humans

Petr Neuzil, Vivek Y. Reddy, Bela Merkely, Laszlo Geller, Levente Molnar, Jacek Bednarek, Krzysztof Bartus, Mark Richey, T. J.Ransbury Bsee, William E. Sanders

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background A percutaneous intravascular cardioverter-defibrillator (PICD) has been developed with a right ventricular (RV) single-coil lead and titanium electrodes in the superior vena cava (SVC)-brachiocephalic vein (BCV) region and the inferior vena cava (IVC). Objective To compare defibrillation thresholds (DFTs) of the PICD with those of a conventional ICD in humans. Methods Ten patients with ischemic cardiomyopathy and ejection fraction ≤35% were randomized to initial testing with either PICD or conventional ICD. A standard dual-coil lead was positioned in the RV apex. If randomized to PICD, the device was placed into the vasculature such that 1 titanium electrode was positioned in the SVC-BCV region and the second in the IVC. For PICD DFTs, the RV coil of the conventional ICD lead was connected to the PICD mandrel [shock vector: RV (+) to SVC-BCV (-) + IVC (-)]. When testing the conventional ICD, a subcutaneous pocket was formed in the left pectoralis region and the ICD was connected to the lead system and positioned in the pocket [shock vector: RV (+) to SVC (-) + active can (-)]. Each device was removed before testing with the other. A step-down binary search protocol determined the DFT, with the initial shock being 9 J. Results The mean PICD DFT was 7.6 ± 3.3 J, and the conventional ICD system demonstrated a mean DFT of 9.5 ± 4.7 J (N = 10; paired t test, P =.28). Conclusion The intravascular defibrillator has DFTs similar to those of commercially available ICDs.

Original languageEnglish
Pages (from-to)210-215
Number of pages6
JournalHeart Rhythm
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 1 2014

Keywords

  • Defibrillation threshold
  • Implantable cardioverter-defibrillator
  • Intravascular defibrillator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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