Surgical aspects of cardioverter defibrillator system

ABSTRACT

Between May 1990 and May 1993, we found an indication for implantation of an AICD in 22 patients in our clinic. A total of 25 AICD have been implanted in these patients, 22 initial implantations and 3 replacements. The group consisted of 20 males and 2 females between 19 and 76 years of age, with a mean age of 57.16 years. In 13 patients [65%], we found advanced coronary sclerosis [4 times this condition occurred after coronary bypass surgery and once after ventricular aneurysmectomy], 3 patients [15%] had a valve replacement, 4 [15%] patients suffered from severe cardiomyopathy, one patient from hypertensive cardiac disease and one patient [5%] from recurrent ventricular fibrillation with congenital long QT syndrome. In all patients, at least 2 incidents of ventricular tachycardia or one circulatory standstill had been observed. The mean left ventricular ejection fraction was 39.9% [10-83%]. All patients had undergone a thorough preoperative diagnostics, including left heart catheterization and electrophysiological tests. The mean period of follow-up is now 12 months [between 1 and 35 months]. In one patient [5%, the first patient], the AICD system was implanted via median sternotomy, in another one via subxyphoidal access and 18 patients [90%], received endocardial leads [transvenous introduction]. We only implanted CPA AICD [6Ventak P, 11 Ventak PRX and 5 Ventak P2]. Implantation criteria were 3 successful shocks lead configuration with The endocardial systems was four times transvenous leads only, 11 times transvenous/subcutaneous Leads twice transvenous leads with epicardial patch leads and three times transvenous leads with an SQ array lead