Effectiveness Evaluation of ICDs Implanted in the Right Side vs. Left Side

Marcio Galindo Kiuchi, Shaojie Chen, Luis Marcelo Rodrigues Paz, Helmut Pürerfellner

Abstract


Background: The implantation of ICDs left pectorally is the conventional normal practice, but pathological reasons may obly to insert the devices on the right side. The aim of our evaluation was to define the outcome of right-sided implantation (n=52) on defibrillation effectiveness in comparison to the left-sided ICD implantation (n=210).

Methods: A cohort of patients received standard therapy for primary or secondary prevention of sudden cardiac death (SCD) in patients with the structural cardiac disease, lay open to the ICD-DR implantation. The 262 individuals who had all the inclusion criteria were comprised in the assessment.

Results: The defibrillation threshold testing (DFT), at the end of implantation showed that the mean energy to revert a programmed induced sustained ventricular tachycardia/ventricular fibrillation was 33.4±6.3 J for the patients that had the ICD implanted on the right side, and 23.9±5.3 J for the ones that presented the ICD positioned on the left side, P<0.0001. However the mean and the sum of shock events recorded by ICD during 1 year of monitoring, according to the side of ICD implantation, did not show any difference.

Conclusion: Our results show that ICD implantation on the right side caused an elevated DFT in comparison to the left side insertion. This study also reported that there is no difference regarding safety and effectiveness about the amount of appropriate and inappropriate shock therapies, the mean and the sum of shock events recorded by ICD during 1 year of monitoring, according to the side of ICD implantation.


Keywords


Ventricular arrhythmia; Automatic implantable cardioverter-defibrillator; Right-sided implantation; Intraoperative test.

Full Text:

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DOI: http://dx.doi.org/10.17987/icfj.v11i0.443

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