title: Defibrillation threshold decrease with the supradiaphragmatic extracardiac implantable cardioverter-defibrillator implantation technique.
abstract: Despite advances in implantable cardioverter-defibrillator (ICD) technology, the optimal ICD implantation technique for pediatric patients has not yet been established. One increasingly used option is totally extracardiac implantation. However, concern exists about the high defibrillation threshold (DFT) at the moment of implantation or during follow-up. We report the case of a 3-year-old boy with repetitive syncopal idiopathic ventricular tachycardia episodes treated with ICD implantation using the extracardiac technique. Changing device position from abdominal to a supradiaphragmatic, solved unsafe elevated discharge impedance and DFT during follow-up.
authors.affiliation: Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Clinic, Barcelona, Catalonia, Spain. berruezo@clinic.ub.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Berruezo
authors.forename: Hrvojka M
authors.initials: HM
authors.lastname: Zeljko
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bartrons
authors.forename: Javier
authors.initials: J
authors.lastname: Mayol
authors.forename: Fredy
authors.initials: F
authors.lastname: Prada
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
mesh_terms: D002675:Child, Preschool; D017147:Defibrillators, Implantable; D017097:Electric Impedance; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods; D011859:Radiography; D013575:Syncope / Q000000981:diagnostic imaging / Q000628:therapy*; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome