Implantation of dual chamber pacemaker defibrillator and placement of endocardial leads via the axillary vein.
OBJECTIVE
To assess the preliminary clinical results of implantation of dual chamber pacemaker defibrillator and to evaluate the safety and effectiveness of placement of endocardial leads in the axillary vein.


METHODS
Seven patients with ventricular tachycardia and/or ventricular fibrillation (VT/VF), associated with bradyanhythmia received implantation of a dual chamber pacemaker defibrillator, including 5 patients with coronary artery disease and 2 patients with dilated cardiomyopathy. The atrial and ventricular leads were introduced via the axillary vein under venographic guidance.


RESULTS
Dual chamber pacemaker defibrillators were successfully implanted in the left chest subcutaneous pocket in 5 patients and the left pectoral muscular pocket in 2 patients. All the VT/VF occurring either inducibly during the procedure or spontaneuously during follow-up were detected promptly and treated successfully. Both the pacing and sensing functions were satisfactory. The endocardial leads required were successfully introduced via the axillary vein without major complications.


CONCLUSIONS
Dual chamber pacemaker defibrillators can provide reliable therapy for VT/VF and the dual chamber pacing function. Placement of endocardial leads via the axillary vein under venographic guidance is safe and effective.
Yang
J
J
Department of Cardiology, Beijing Hospital, Beijing 100730, China.
Powell
A
A
Davis
M
M
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D001367:Axillary Vein; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000628:therapy; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000628:therapy