Superiority of endocardial versus epicardial implantation of the implantable cardioverter defibrillator (icd)

W. Saggau, F. U. Sack, R. Lange, C. Werling, R. De Simone, J. Brachmann, S. Hagl

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

The implantable cardioverter-defibrillator (ICD) has proved to be an efficient device for the treatment of severe ventricular tachyarrhythmias (VT). From May 1985 to August 1991, the ICD was implanted in 107 patients of whom 72% suffered from coronary artery disease, 17% from cardiomyopathy, 5% from long QT-syndrome and 6% from other heart disease. All patients had a life threatening episode of VT or at least one episode of ventricular fibrillation. Of 107 implants, 12% were combined with other heart surgery, 55% were isolated epicardial implantations (epi I) and in 33%, the novel endocardial (endo I) approach was chosen. Between epi I and endo I we found no difference in operation time, but time for ICU and in-hospital stay was significantly shorter using the transvenous approach. In addition, sensing and pacing capability of the endocardial screw-in electrode was superior and the need for thoracotomy was avoided, a particular advantage in patients with previous heart surgery. Complications after epi I were: temporary low cardiac output, 1; perioperative death, 2; infection, 3, and after endo I: electrode dislocation, 2. Hence, endo I may become the method of choice for patients without concomitant surgery. [Eur J Cardio-thorac Surg (1992) 6:195-200].

Original languageEnglish
Pages (from-to)195-200
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume6
Issue number4
DOIs
StatePublished - Apr 1992
Externally publishedYes

Keywords

  • Endocardial lead system
  • Epicardial lead system
  • Implantable cardioverter-defibrillator
  • Median sternotomy
  • Sudden cardiac death
  • Transvenous approach

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