title: Video-assisted thoracoscopic implantation of cardioverter-defibrillator systems.
abstract: Implantation of cardioverter-defibrillators in patients with limited venous access due to recurrent infections, thrombosis, or congenital anomalies can be challenging. For this subset of patients, we performed a video-assisted thoracoscopic intrapericardial implantation using standard shock electrodes and epicardial leads. The pulse generator was placed in pectoral or subcostal position. All pacing and sensing parameters and defibrillation thresholds were satisfactory and stable in time. No major complications were reported. Our limited experience suggests that this technique is a potential alternative in patients where endocardial implantation should be avoided.
authors.affiliation: Department of Cardiac Surgery, Centrum voor Hart- en Vaatziekten, Universitair Ziekenhuis Brussel, Brussels, Belgium. Electronic address: jens.czapla@uzbrussel.be.
authors.forename: Jens
authors.initials: J
authors.lastname: Czapla
authors.affiliation: Department of Cardiac Surgery, Centrum voor Hart- en Vaatziekten, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Wellens
authors.affiliation: Department of Cardiac Surgery, Centrum voor Hart- en Vaatziekten, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Nijs
authors.affiliation: Department of Cardiac Surgery, Centrum voor Hart- en Vaatziekten, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult