Transvenous pectoral implantation of single lead implantable cardioverter defibrillator.
OBJECTIVE
To report our initial experience of transvenous pectoral implantation of single lead implantable cardioverter defibrillator (ICD) in fifteen patients.


METHODS
Fifteen patients (male 13, female 2, mean age of 51.7 years), including dilated cardiomyopathy in 4, hypertrophic cardiomyopathy in 2, coronary artery disease in 5 and syncope of unknown etiology in 2, underwent ICD implantation. Indications for ICD implantation were ventricular fibrillation (8 patients) and refractory ventricular tachycardia (7 patients). All patients had syncope out of hospital. The ICD system were Medtronic Jewel active can in 5 patients (Model 7219C in 2, 7220C in 3) and CPI Ventak PRxIII in 9 patients. For active can, shocks were delivered through distal coil to ICD shell and for PRxIII through the endotak lead of proximal to distal coil. Successful implantation criteria was 2 consecutive defibrillation at less than 24 J.


RESULTS
All 15 patients had successful implantation using single lead ICD system in catheter laboratory. The mean defibrillation threshold was 12.8 J (5-15 J) and R wave was 9.9 mV (3.7-14.6 mV). All devices were of pectoral implantation. No operative and perioperative complications occurred. In 7.6 months (1-18 months) of follow-up, 3 patients had VT terminated by antitachycardia pacing (ATP) and 1 patient VF terminated by shock.


CONCLUSIONS
Transvenous pectoral implantation of single lead ICD is easy to perform and has high defibrillation efficacy and should be a preferred approach.
Wang
F
F
Fu Wai Hospital, Beijing 100037, China.
Hua
W
W
Chen
X
X
D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014693:Ventricular Fibrillation / Q000628:therapy*