In young patients with transvenous implantable cardioverter defibrillations (TV-ICDs), the possibility of device infection or lead fracture would be high in their long lifetimes. Furthermore, the risk of lead removal will gradually increase over the years. We reported two cases of subcutaneous ICDs implantation following removal of TV-ICDs. Patient 1, 35-year-old man, underwent TV-ICD implantation 9 years ago for idiopathic ventricular fibrillation, and Patient 2, 46-year-old man, underwent TV-ICD implantation 8 years ago for asymptomatic Brugada syndrome. In both cases, the electrical performance was stable, and there was no incidence of arrythmia or no pacing demand during the follow-up duration. Considering future risk of device infection or lead fracture, and difficulty in future lead removal, TV-ICDs were removed with sufficient informed consent, and then, subcutaneous ICDs (S-ICDs) implantation were performed as an alternative to them. Although indication of the TV-ICD removal should be carefully considered in individual cases, long-term risks leaving it in place should be also considered in the management of young patient.
In young patient with TV-ICD, even for a normally functioning non-infected lead, S-ICD implantation following removal of the TV-ICD would represent a strategy associated with less long-term risks than leaving it in place.
Abbreviations:TV-ICD (transvenous implantable cardioverter defibrillator), S-ICD (subcutaneous implantable cardioverter defibrillator), VF (ventricular fibrillation), SVC (superior vena cava), CT (computed tomography), ECG (electro-cardiogram), MRI (magnetic resonance imaging)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Cardiology Cases
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias.J Arrhythm. 2021; 37: 709-870
- Guidelines for non-pharmacotherapy of cardiac arrhythmias (JCS 2011).Circ J. 2013; 77: 249-274
- 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction.Heart Rhythm. 2017; 14: e503-e551
- Risk stratification of patients undergoing transvenous lead extraction with the ELECTRa Registry Outcome Score (EROS): an ESC EHRA EORP European lead extraction ConTRolled ELECTRa registry analysis.Europace. 2021; 23: 1462-1471
- Subcutaneous implantable cardioverter-defibrillators: long-term results of the EFFORTLESS study.Eur Heart J. 2022; 43: 2037-2050
Published online: March 11, 2023
Accepted: February 24, 2023
Received in revised form: February 22, 2023
Received: October 6, 2022
Publication stageIn Press Corrected Proof
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.