Implantation and Follow-Up of an Extravascular ICD After a Challenging Transvenous System Extraction: A Case Report.

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-04-01 Epub Date: 2025-03-08 DOI:10.1111/pace.15170
Domenico M Carretta, Rossella Troccoli, Gianluca Epicoco, Ilenia Pastore, Nicola Di Bari, Carlo D'Agostino, Tomaso Bottio
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引用次数: 0

Abstract

The Extravascular ICD (EV-ICD) is implanted outside of the patient's heart and vascular system. The defibrillation lead is tunneled in the substernal space, very close to the surface of the heart, thus allowing for additional pacing capabilities such as Post Shock Pacing, Anti-Tachycardia Pacing (ATP), and Pause Prevention Pacing. Early studies demonstrated the safety and efficacy profile of the EV-ICD, but patients with previous or existing cardiac devices or leads were excluded. In this case report we describe the implantation of an EV-ICD in a 68-year-old male patient, who had undergone a challenging extraction of a previous transvenous system due to infection and screened negative for a subcutaneous ICD (S-ICD). Given the lack of upper and lower venous accesses, it was also necessary to implant an epicardial bipolar lead connected to a single-chamber pacemaker as a backup during extraction, which also remained in place chronically. Follow-up was uneventful through the following 10 months, with stable system parameters and no infection relapse.

经静脉系统取出后血管外ICD的植入和随访:1例报告。
血管外ICD (EV-ICD)被植入患者心脏和血管系统外。除颤导联在胸骨下空间中隧道化,非常接近心脏表面,从而允许额外的起搏功能,如休克后起搏,抗心动过速起搏(ATP)和暂停预防起搏。早期研究证实了EV-ICD的安全性和有效性,但排除了先前或现有心脏装置或导联的患者。在本病例报告中,我们描述了一名68岁男性患者的EV-ICD植入,该患者由于感染而经历了先前经静脉系统的艰难提取,并且皮下ICD (S-ICD)筛查呈阴性。由于缺乏上下静脉通道,在拔牙过程中也有必要植入连接单室起搏器的心外膜双极导联作为备用,并长期保持原位。随访10个月顺利,系统参数稳定,无感染复发。
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来源期刊
Pace-Pacing and Clinical Electrophysiology
Pace-Pacing and Clinical Electrophysiology 医学-工程:生物医学
CiteScore
2.70
自引率
5.60%
发文量
209
审稿时长
2-4 weeks
期刊介绍: Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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