Open AccessHigh defibrillation threshold with a subcutaneous implantable cardiac defibrillator due to the lead having been positioned in the fat layer
Author(s) -
Hirao Tatsuhiko,
Nitta Junichi,
Sato Akira,
Takahashi Yoshihide,
Goya Masahiko,
Hirao Kenzo
Publication year - 2018
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12033
Subject(s) - medicine , defibrillation threshold , defibrillation , implantable cardioverter defibrillator , ventricular fibrillation , cardiology , lead (geology) , sternum , shock (circulatory) , fluoroscopy , surgery , geomorphology , geology
A 46‐year‐old female with a body mass index of 38.9 kg/m 2 and no organic heart disease underwent a subcutaneous implantable cardioverter‐defibrillator implantation for secondary prevention of sudden cardiac death in the setting of idiopathic ventricular fibrillation. Defibrillation threshold ( DFT ) testing during implantation detected high shock impedance and high DFT . Fluoroscopy revealed subcoil fat between the lead and the sternum, which we suspected was the reason for the high shock impedance and high DFT . We repositioned the lead to a site just above the sternum and the shock impedance and DFT improved to within the respective normal ranges.