TY - JOUR
T1 - Superiority of endocardial versus epicardial implantation of the implantable cardioverter defibrillator (icd)
AU - Saggau, W.
AU - Sack, F. U.
AU - Lange, R.
AU - Werling, C.
AU - De Simone, R.
AU - Brachmann, J.
AU - Hagl, S.
PY - 1992/4
Y1 - 1992/4
N2 - 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].
AB - 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].
KW - Endocardial lead system
KW - Epicardial lead system
KW - Implantable cardioverter-defibrillator
KW - Median sternotomy
KW - Sudden cardiac death
KW - Transvenous approach
UR - http://www.scopus.com/inward/record.url?scp=0026494094&partnerID=8YFLogxK
U2 - 10.1016/1010-7940(92)90216-K
DO - 10.1016/1010-7940(92)90216-K
M3 - Article
C2 - 1586494
AN - SCOPUS:0026494094
SN - 1010-7940
VL - 6
SP - 195
EP - 200
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 4
ER -