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Case Reports
. 2024 Oct 15;15(10):6062-6065.
doi: 10.19102/icrm.2024.15104. eCollection 2024 Oct.

Implantation of an Extravascular Implantable Defibrillator Using a Substernal Lead in a Patient with Previous Cardiac Surgery

Alexander Breitenstein  1 , Jean-Yves Delaite  2 , Nicolas Dayal  3
Affiliations
Case Reports

Implantation of an Extravascular Implantable Defibrillator Using a Substernal Lead in a Patient with Previous Cardiac Surgery

Alexander Breitenstein et al. J Innov Card Rhythm Manag. .

Abstract

We present the case of a 52-year-old man suffering from malignant mitral valve prolapse syndrome. He underwent a right-sided thoracotomy for mitral valve repair but required implantable cardioverter-defibrillator (ICD) implantation 4 years later. He chose the option of a substernal ICD, which was implanted successfully without any complications and good electrical parameters.

Keywords: Cardiac surgery; extravascular ICD; substernal lead; thoracotomy.

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Conflict of interest statement

Dr. Breitenstein has received consulting/presenter fees from Abbott, Bayer Health Care, Biosense Webster, Biotronik, BMS/Pfizer, Boston Scientific, Cook Medical, Daiichi Sankyo, Medtronic, and Spectranetics/Philips. N. Dayal reports speaker fees from Medtronic. J.-Y. Delaite reports no conflicts of interest for the published content. No funding information was provided.

Figures

Figure 1:
Figure 1:
A: A chest computed tomography scan showing the distance between the posterior border of the sternum and the anterior cardiac structures. B: Note the internal mammary arteries are not in proximity to the lateral border of the sternum.
Figure 2:
Figure 2:
A chest X-ray taken after extravascular implantable cardioverter-defibrillator implantation showing the correct position of the lead substernally (B) and of the coils facing toward the patient’s right side, while the sensing electrodes (Ring 1/Ring 2) are facing toward the left (A).
See this image and copyright information in PMC

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References

    1. Sabbag A, Essayagh B, Barrera JDR, et al. EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society. Europace. 2022;24(12):1981–2003. doi: 10.1093/europace/euac125. - DOI - PMC - PubMed
    1. Friedman P, Murgatroyd F, Boersma LVA, et al. Efficacy and safety of an extravascular implantable cardioverter-defibrillator. N Engl J Med. 2022;387(14):1292–1302. doi: 10.1056/NEJMoa2206485. - DOI - PubMed
    1. Chan JYS, Lelakowski J, Murgatroyd FD, et al. Novel extravascular defibrillation configuration with a coil in the substernal space: the ASD clinical study. JACC Clin Electrophysiol. 2017;3(8):905–910. doi: 10.1016/j.jacep.2016.12.026. - DOI - PubMed
    1. Boersma LVA, Merkely B, Neuzil P, et al. Therapy from a novel substernal lead: the ASD2 study. JACC Clin Electrophysiol. 2019;5(2):186–196. doi: 10.1016/j.jacep.2018.11.003. - DOI - PubMed
    1. Bittar MN, Barnard JB, Khasati N, Richardson S. Should the pericardium be closed in patients undergoing cardiac surgery? Interact Cardiovasc Thorac Surg. 2005;4(2):151–155. doi: 10.1510/icvts.2004.100388. - DOI - PubMed

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