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Right Side Implant of the Unipolar Single Lead Defihrillation System
Author(s) -
NATALE ANDREA,
SRA JASBIR,
GEIGER MARY JANE,
NEWBY KEITH,
AKHTAR MASOOD,
PACIFICO ANTONIO
Publication year - 1997
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.1540-8159.1997.tb03595.x
Subject(s) - medicine , defibrillation , defibrillation threshold , ventricle , cardiology , lead (geology) , ventricular fibrillation , implant , surgery , geomorphology , geology
The active can defibrillator has been designed for implantation in the left prepectoral region. Whether this system can be successfully implanted on the right side is unknown. We describe six cases in which placement of the unipolar single lead defibrillation system was successfully attempted in the right prepectoral region due to impediments on the left side. The mean age of the patients was 62 ± 12 years. Five patients had is–chemic heart disease and one idiopathic dilated cardiomyopathy. The endocardial defibrillation electrode was placed in the right ventricle through the right subclavian vein and positioned at the apex in two patients and in the septal position in four patients. Defibrillation threshold testing was performed using a step‐up/step‐down protocol beginning at 12 J with 3‐J increments or decrements. Defibrillation threshold was defined as the lowest energy of the first shock able to terminate ventricular fibrillation. The generator models used were the Medtronic 7218C in 1 patient, the Medtronic 7219C in 3 patients, and the Ventritex Cadet 115 AC in 2 patients. The mean defibrillation threshold was 15 ± 3 J. The defibrillation thresholds were retested at 1,3, and 6 months, and showed no significant change in five patients but decreased from 15 J to 12 J in one patient. The presence of impediments on the left side should not preclude attempts to place the unipolar active can system in the right prepectoral region.