title: Azygos vein lead implantation: a novel adjunctive technique for implantable cardioverter defibrillator placement.
abstract: High defibrillation thresholds (DFTs) occasionally are encountered during placement of implantable cardioverter defibrillators (ICDs). There are multiple strategies to lower DFTs in such patients, including reassessment of right ventricular lead position, alteration of the shock waveform, and implantation of subcutaneous arrays. This article describes a novel technique of implanting a high-voltage lead in the azygos vein. This procedure may serve as an adjunctive approach to reduce DFTs. The anatomic location of the azygos vein posterior to the heart provides a suitable shocking vector between the right ventricular electrode, a high-voltage lead placed in the azygos vein, and the ICD can.
authors.affiliation: UCLA Cardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1679, USA.
authors.forename: David
authors.initials: D
authors.lastname: Cesario
authors.forename: Mandeep
authors.initials: M
authors.lastname: Bhargava
authors.forename: Miguel
authors.initials: M
authors.lastname: Valderrábano
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.forename: Bruce
authors.initials: B
authors.lastname: Wilkoff
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
mesh_terms: D000328:Adult; D001401:Azygos Vein; D009202:Cardiomyopathies / Q000628:therapy*; D002311:Cardiomyopathy, Dilated; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged