Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 15;11(5):4100-4105.
doi: 10.19102/icrm.2020.110504. eCollection 2020 May.

Approaches to Minimizing Periprocedural Complications During Subcutaneous Implantable Cardioverter-defibrillator Placement

Srikanth Vedachalam  1 , Schuyler Cook  2 , Tanner Koppert  1 , Toshimasa Okabe  1 , Raul Weiss  1 , Muhammad R Afzal  1
Affiliations

Approaches to Minimizing Periprocedural Complications During Subcutaneous Implantable Cardioverter-defibrillator Placement

Srikanth Vedachalam et al. J Innov Card Rhythm Manag. .

Abstract

The subcutaneous implantable cardioverter-defibrillator (S-ICD) is the latest option among devices clinically available for the prevention of sudden cardiac death, with experience from previous trials and postmarketing studies supporting the feasibility and safety of this kind of system. The extracardiac positioning of the S-ICD obviates the need for transvenous leads, which translates into lower incidence rates of lead-related complications and systemic infections. This review will highlight the results of pertinent studies related to the perioperative management of S-ICDs and review potential approaches to minimizing the risk of complications such as hematoma at the pulse generator location, unsuccessful defibrillation due to suboptimal S-ICD lead and generator positioning, and postoperative pain. An extensive literature search using PubMed was conducted to identify relevant articles.

Keywords: Complications; periprocedural; subcutaneous implantable cardioverter-defibrillator.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest for the published content.

Figures

Figure 1:
Figure 1:
Proper positioning of the S-ICD pulse generator in the lateral pocket.
Figure 2:
Figure 2:
Identification of the fascial plane between the latissimus dorsi and the serratus anterior.
Figure 3:
Figure 3:
Twisting of the electrode, resulting in Twiddler’s syndrome.
Figure 4:
Figure 4:
Demonstrations of lighted retractor application to illuminate the lateral pocket.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kamp NJ, Al-Khatib SM. The subcutaneous implantable cardioverter-defibrillator in review. Am Heart J. 2019;217:131–139. doi: 10.1016/j.ahj.2019.08.010. - DOI - PubMed
    1. Pfenniger A, Knight BP. Evolution of extravascular implantable defibrillator technologies. Prog Cardiovasc Dis. 2019;62(3):249–255. [CrossRef] [PubMed] - DOI - PubMed
    1. Santini M, Cappato R, Andresen D, et al. Current state of knowledge and experts’ perspective on the subcutaneous implantable cardioverter-defibrillator. J Interv Card Electrophysiol. 2009;25(1):83–88. [CrossRef] [PubMed] - DOI - PubMed
    1. van Dijk VF, Boersma LV. The subcutaneous implantable cardioverter defibrillator in 2019 and beyond. Trends Cardiovas Med. 2019 Oct 1; doi: 10.1016/j.tcm.2019.09.006. [Epub ahead of print]. - DOI - PubMed
    1. Burke MC, Gold MR, Knight BP, et al. Safety and efficacy of the totally subcutaneous implantable defibrillator: 2-year results from a pooled analysis of the IDE study and EFFORTLESS registry. J Am Coll Cardiol. 2015;65(16):1605–1615. [CrossRef] [PubMed] - DOI - PubMed

LinkOut - more resources