PMID- 1873038
OWN - NLM
STAT- MEDLINE
DCOM- 19910925
LR  - 20190510
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 5
IP  - 6
DP  - 1991
TI  - Implantable cardioverter/defibrillators (ICD): a new lead-system using 
      transvenous-subcutaneous approach in patients with prior cardiac surgery.
PG  - 315-8
AB  - The current approach in cardioverter-defibrillator implantation requires 
      placement of epicardial leads which may lead to pericardial and/or pleural 
      effusion and pneumonia during the perioperative period. Although ICD implantation 
      is less invasive than other surgical techniques for the treatment of rhythm 
      disturbances, the perioperative mortality must be considered. Minimizing the 
      operative procedure could lead to a reduction in perioperative mortality. 
      Therefore, we investigated an approach without the need for thoracotomy using a 
      transvenous/subcutaneous lead system. In nine patients with prior cardiac 
      surgery, defibrillator implantation was performed by a transvenous/subcutaneous 
      approach. There was no perioperative mortality. In all patients, a sufficient 
      defibrillation threshold was achieved. The defibrillation pulses were delivered 
      as two sequential pulses between a right ventricular electrode (cathode) and a 
      coronary sinus or superior caval vein electrode (anode 1) and a subcutaneous 
      patch electrode (anode 2). Intubation of the coronary sinus was necessary in 4 
      patients in order to obtain satisfactory defibrillation thresholds. These data 
      demonstrate that a transvenous/subcutaneous approach is feasible in patients with 
      prior cardiac surgery obviating the need for thoracotomy. Sensing function of the 
      RV-electrode, intubation of the coronary sinus and the intraoperative use of an 
      epicutaneous patch electrode are current problems of this new technique.
FAU - Hammel, D
AU  - Hammel D
AD  - Department of Thoracic and Cardiovascular Surgery, Hospital of the Westphalian 
      Wilhelms University, Munster, FRG.
FAU - Block, M
AU  - Block M
FAU - Hachenberg, T
AU  - Hachenberg T
FAU - Borggrefe, M
AU  - Borggrefe M
FAU - Budde, T
AU  - Budde T
FAU - Soeparwata, R
AU  - Soeparwata R
FAU - Konertz, W
AU  - Konertz W
FAU - Hief, C
AU  - Hief C
FAU - Geywitz, H J
AU  - Geywitz HJ
FAU - Breithardt, G
AU  - Breithardt G
AU  - et al.
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
CIN - Eur J Cardiothorac Surg. 1992;6(7):394. PMID: 1497934
MH  - Adult
MH  - Aged
MH  - *Cardiac Surgical Procedures/mortality
MH  - Death, Sudden/etiology
MH  - Electric Countershock/instrumentation/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ventricular Fibrillation/*therapy
EDAT- 1991/01/01 00:00
MHDA- 1991/01/01 00:01
CRDT- 1991/01/01 00:00
PHST- 1991/01/01 00:00 [pubmed]
PHST- 1991/01/01 00:01 [medline]
PHST- 1991/01/01 00:00 [entrez]
AID - 10.1016/1010-7940(91)90042-i [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 1991;5(6):315-8. doi: 10.1016/1010-7940(91)90042-i.