Comparison of right- and left-sided pectoral implantation parameters with the Jewel active can cardiodefibrillator. The World Wide Jewel Investigators.
A total of 1,207 patients received a Medtronic Jewel active can ICD (models 7218C, 7219C), with a Transvene lead in 97 centers in Europe and North America. Nineteen implants were from the right pectoral region. Patients with right-sided ICDs did not differ in terms of mean age, % male, left ventricular ejection fraction, New York Heart Association Functional Class, antiarrhythmic drug therapy, indication for the implantable cardioverter defibrillator, and R wave values at implantation, but tended to have slightly higher pacing thresholds (1.2 +/- 0.5 V vs 1.0 +/- 0.6 V, P = 0.012) and higher defibrillation thresholds (14.7 +/- 6.4 J vs 11.5 +/- 6 J, P = 0.11) compared with patients with left sided implants. Patients with right-sided implants had a longer implantation time compared with patients with left-sided implants (118 +/- 70 minutes vs 91 +/- 46 minutes, P = 0.074). In follow-up, 5 patients with right-sided implantation received successful therapy for either ventricular fibrillation, (8 episodes) or ventricular tachycardia (5 episodes). No ineffective therapy from the device was delivered in any patients with right-sided implantation. Right-sided pectoral implants are feasible with the Medtronic Jewel active can ICD.
Flaker
G C
GC
University of Missouri Hospital, Division of Cardiology, Columbia, USA.
Tummala
R
R
Wilson
J
J
D000328:Adult; D016009:Chi-Square Distribution; D017147:Defibrillators, Implantable; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery*; D018709:Statistics, Nonparametric; D017180:Tachycardia, Ventricular / Q000628:therapy; D014693:Ventricular Fibrillation / Q000628:therapy