HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Dieter Hammel Armin Geiger Thomas Stadlbauer Hans H. Scheld Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hammel, D. Articles by Scheld, H. H. Search for Related Content PubMed PubMed Citation Articles by Hammel, D. Articles by Scheld, H. H.

Ann Thorac Surg 1994;58:1614-1616
© 1994 The Society of Thoracic Surgeons

---

Articles

Single-incision implantation of cardioverter defibrillators using nonthoracotomy lead systems

Departments of Cardiovascular Surgery and Cardiology, Hospital of the Westphalian Wilhelms University of Muenster, Muenster, Germany

Accepted for publication April 8, 1994.

^_* Address reprint requests to Dr Hammel, Department of Cardiovascular Surgery, Hospital of the Westphalian Wilhelms University of Muenster, D-48129 Muenster, Federal Republic of Germany.

This study describes the placement of a newly designed implantable cardioverter defibrillator in a subpectoral device pocket using the incision for venous access in 16 patients undergoing implantation of an implantable cardioverter defibrillator with a nonthoracotomy lead system. The endocardial lead system consisted of a right atrial/superior vena cava defibrillation spring electrode and a right ventricular bipolar sensing/defibrillation electrode, inserted by cephalic venotomy or by puncturing of the subclavian vein. As a result of intraoperative testing using biphasic shocks the defibrillation threshold (DFT) had to be less than 24 J, otherwise an additional subcutaneous patch electrode was placed in the lateral chest wall near the cardiac apex through another incision. All patients received a nonthoracotomy lead system in combination with a subpectoral device placement. In 11 of 16 patients the endocardial leads alone were sufficient (DFT, 13.4 ± 7.0 J), 5 of 16 patients (31%) required an additional subcutaneous patch electrode to achieve proper device function (DFT, 14.6 ± 9.0 J). The operation lasted 93 ± 20 minutes. This was a significant (p < 0.05) lower time consumption than standard nonthoracotomy approach combined with abdominal device placement (120 ± 50 minutes). There were no postoperative complications. During follow-up period (average, 4 months), none of the patients reported major local symptoms, especially no device migration occurred. This approach, in contrast to an abdominal device placement, avoids another incision and subcutaneous tunneling of leads. In 11 of 16 patients defibrillator implantation by a single incision in the deltoideopectotal groove was possible.

This article has been cited by other articles:

				W. R. Wilson, G. E. Greer, and B. P. Grubb Implantable Cardioverter-Defibrillators in Children: A Single-Institutional Experience Ann. Thorac. Surg., March 1, 1998; 65(3): 775 - 778. [Abstract] [Full Text] [PDF]

				K J Lipscomb, N J Linker, and A P Fitzpatrick Subpectoral implantation of a cardioverter defibrillator under local anaesthesia Heart, March 1, 1998; 79(3): 253 - 255. [Abstract] [Full Text]

				A. H. Harken and J. L. Cox ICDs, VT, VF, and the AATS and STS Ann. Thorac. Surg., December 1, 1994; 58(6): 1572 - 1572. [PDF]