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Novel Use of a Vascular Plug to Anchor an Azygous Vein ICD Lead
Author(s) -
BARCOHEN YANIV,
TAKAO CHERYL M.,
WELLS WINFIELD J.,
SAXON LESLIE A.,
CESARIO DAVID A.,
SILKA MICHAEL J.
Publication year - 2010
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2009.01510.x
Subject(s) - medicine , lead (geology) , defibrillation threshold , cardiology , defibrillation , implantable cardioverter defibrillator , atrial fibrillation , implant , tachycardia , ventricular fibrillation , surgery , geomorphology , geology
Vascular Plug for ICD Lead. We describe the case of a young patient with severe hypertrophic cardiomyopathy and marginal defibrillation thresholds (DFTs) at implant of a standard transvenous implantable cardioverter‐defibrillator (ICD) system. The patient subsequently experienced multiple failed ICD shocks during a prolonged episode of spontaneous ventricular tachycardia/fibrillation. Placement of a second single‐coil shocking lead in the azygous vein resulted in acceptable DFTs, but the new lead migrated superiorly within hours of the procedure. To stabilize the lead position, a vascular plug was placed in the distal azygous vein, and the shocking lead screw was actively fixated to the meshwork of the device. Subsequent testing confirmed both adequate defibrillation and stable lead position. (J Cardiovasc Electrophysiol, Vol. 21, pp. 99–102, January 2010)