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Revised Implantation Procedure for Programmable Automatic Implantable Cardioverter Defibrillator: Don't Discard the Magnet
Author(s) -
VENDITTI FERDINAND J.,
MARTIN DAVID,
TSUJI HISAKO,
SHAHIAN DAVID M.,
BOWEN SUSAN
Publication year - 1990
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1990.tb02104.x
Subject(s) - medicine , troubleshooting , implantable cardioverter defibrillator , magnet , biomedical engineering , electrical engineering , cardiology , computer science , operating system , engineering
The newest implantable defibrillator (Ventak 1550 AICD) introduces radiofrequency telemetric communication that obviates the need for activation and deactivafion of the device by a magnet during implantation. We present three of our first ten cases of implantation in which difficulties in intraoperative sensing would have been undetected without use of the magnet for audible evaluation of sensing. Based on this experience, we recommend a revised implantation protocol in which audible confirmation of sensing for 30 to 60 seconds by means of a sterile magnet is performed twice (with a pacemaker, if present in DOO or VOO mode): at the time of system test before induction of arrhythmia with testing cables connected to permit recording of rate, morphology, and ECG interpretation channel signals; and after final connection of the leads to the AICD. This simple additional maneuver is a powerful troubleshooting tool during implantation that permits prompt identification of sensing problems.