Abstract
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.
Learning objective
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)Keywords
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References
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Article info
Publication history
Published online: March 11, 2023
Accepted:
February 24,
2023
Received in revised form:
February 22,
2023
Received:
October 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
