Use of a single coil transvenous electrode with an abdominally placed implantable cardioverter defibrillator in children

被引:14
作者
Fischbach, PS [1 ]
Law, IH [1 ]
Dick, M [1 ]
Leroy, S [1 ]
Mosca, RS [1 ]
Serwer, GA [1 ]
机构
[1] Univ Michigan, Congenital Heart Ctr, Ann Arbor, MI 48109 USA
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2000年 / 23卷 / 05期
关键词
defibrillator; children; arrhythmia; abdominal implant;
D O I
10.1111/j.1540-8159.2000.tb00859.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
While transvenous defibrillator electrode placement avoiding a thoracotomy is preferable, electrode size, a large intercoil spacing, and the need for subclavicular device placement preclude this approach in most children. We investigated a single RV coil to an abdominally placed active can ICD device. Five children ages 8-16 years (weight 21-50 kg, mean 35 kg) underwent ICD placement. Placement of a single coil Medtronic model 6932 or 6943 electrode was performed via the left subclavian vein approach and the electrode positioned in the RV apex with the coil lying along the RV diaphragmatic surface. The ICD (Medtronic Micro Jewel II model 7223Cx) was implanted in a left abdominal pocket with the lead tunneled from the infraclavicular region to the pocket. Implant DFTs were less than or equal to 15 J using a biphasic waveform. DFTs rechecked within 3-month postimplant were unchanged. Lead impedance at implant ranged from 38 to 56 Omega, mean 51 Omega. Follow-up wets 3-21 months (total 82 months) with no electrode dislodgment, lead fractures, or inappropriate discharges. Two of the five patients have hard successful appropriate ICD discharges. Transvenous ICD electrode placement can be performed in children as small as 20 kg with the device implanted in a cosmetically acceptable abdominal pocket that is well tolerated. Excellent DFTs can be achieved. This approach avoids a thoracotomy in all but the smallest child, does not require subclavicular placement of the device, and avoids use of a second intravascular coil.
引用
收藏
页码:884 / 887
页数:4
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