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• W4286312513 abstract "Implantable cardioverter defibrillators (ICDs) reduce mortality among those at high risk of sudden cardiac death. Subcutaneous ICDs (S-ICDs) are an attractive alternative to transvenous ICDs among those not requiring pacing. However, the risk of damage to the S-ICD electrode during sternotomy and of oversensing due to interaction with sternal wires has not been defined. To determine the risk of S-ICD electrode damage, as well as oversensing of electrical noise due to interactions between the S-ICD electrode and sternal wires. Retrospective study of all patients implanted with a S-ICD between 2010 and 2021 at a single academic medical center. All S-ICDs were implanted under fluoroscopy. The electronic medical record of each S-ICD recipient was searched to identify those undergoing a median sternotomy before or after S-ICD implantation. Adverse events were sought, including damage to the S-ICD electrode, change in lead impedance, oversensing of electrical noise and failure to terminate spontaneous ventricular arrhythmias. Among 392 patients who underwent S-ICD implantation, 41 had undergone sternotomy before S-ICD implantation and 6 underwent sternotomy after S-ICD implantation. The majority (79%) were men. Mean age was 48 ± 15 years, BMI 29 ± 7 and LVEF 40 ± 20%. Primary prevention was the indication in 74%, and 36% had ischemic cardiomyopathy. The median time between sternotomy and S-ICD implantation was 59 months (range 1-531). The median time between S-ICD implantation and sternotomy was 14 months (range 4-28). DFT testing was successful in all patients that underwent testing (n=37), with mean shock impedance 67 ± 20 ohms; 1 patient required shock polarity reversal. Among those undergoing sternotomy after S-ICD implant, no lead fractures or major changes in impedance occurred. There were no inappropriate shocks among the entire cohort of 47 patients due to electrical noise artifact or ineffective shocks for spontaneous arrhythmias. Six patients received inappropriate shocks due to T wave oversensing. Patients with pre-existing S-ICDs can safely undergo sternotomy without high risk of lead damage. In addition, the risk of interaction between the S-ICD electrode and sternal wires appears low." @default.
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• W4286312513 date "2022-05-01" @default.
• W4286312513 modified "2023-09-30" @default.
• W4286312513 title "PO-633-05 MEDIAN STERNOTOMY BEFORE OR AFTER SUBCUTANEOUS ICD IMPLANTATION DOES NOT DAMAGE LEAD OR RESULT IN OVERSENSING" @default.
• W4286312513 doi "https://doi.org/10.1016/j.hrthm.2022.03.921" @default.
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