Single Coil Implantable Cardioverter Defibrillator Leads in Patients With Hypertrophic Cardiomyopathy
Patients with hypertrophic cardiomyopathy (HC) may require higher energies to terminate ventricular fibrillation (VF); thus, dual coil defibrillation leads are often implanted. However, single coil leads may be preferred in young patients. All patients with HCM implanted with a transvenous ICD from...
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| Veröffentlicht in: | The American journal of cardiology 2020-06, Vol.125 (12), p.1896-1900 |
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| container_title | The American journal of cardiology |
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| creator | Kumar, Kartik R. Mandleywala, Swati N. Madias, Christopher Weinstock, Jonathan Rowin, Ethan J. Maron, Barry J Maron, Martin S. Link, Mark S. |
| description | Patients with hypertrophic cardiomyopathy (HC) may require higher energies to terminate ventricular fibrillation (VF); thus, dual coil defibrillation leads are often implanted. However, single coil leads may be preferred in young patients. All patients with HCM implanted with a transvenous ICD from years 2000 to 2014 were included. Of 249 patients, 223 underwent VF testing including 150 with a dual coil lead and 73 a single coil. Patients tested with dual coil compared with single coil had lower successful VF energies (15.7 ± 6.1 joule to 20.2 ± 7.9 joule (p |
| doi_str_mv | 10.1016/j.amjcard.2020.03.011 |
| format | Article |
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However, single coil leads may be preferred in young patients. All patients with HCM implanted with a transvenous ICD from years 2000 to 2014 were included. Of 249 patients, 223 underwent VF testing including 150 with a dual coil lead and 73 a single coil. Patients tested with dual coil compared with single coil had lower successful VF energies (15.7 ± 6.1 joule to 20.2 ± 7.9 joule (p <0.0001)). Adequate safety margin for defibrillation was noted in 97.3% of patients. Notably, 6 (4 with single coil leads) had inadequate safety margins (defined as ≥10 joule). Three of these 6 patients required replacement of a single coil lead with a dual coil lead. The remaining 3 underwent waveform tilt alteration, higher energy ICD, or removal of the can from the shock vector. There were no clinical or implant predictors of inadequate safety margins. In follow-up of 16 ± 30 months (range 0 to 170), there were 24 arrhythmias including 13 VF, all successfully terminated. In conclusion, in HC patients undergoing ICD implantation, single coil leads can provide adequate safety margins. In conclusion, defibrillation testing should be considered in all HC patients undergoing ICD implantation, and should be performed in those undergoing implantation with a single coil lead.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2020.03.011</identifier><identifier>PMID: 32305220</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiac arrhythmia ; Cardiomyopathy ; Defibrillators ; Ejection fraction ; Failure ; Fibrillation ; Implantation ; Patients ; Safety ; Safety margins ; Transplants & implants ; Ventricle ; Ventricular fibrillation ; Waveforms</subject><ispartof>The American journal of cardiology, 2020-06, Vol.125 (12), p.1896-1900</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-cbe587960f630a56d6466de6e6bbe8c6b87099c57110e9b27a62c2fbe1f56ffc3</citedby><cites>FETCH-LOGICAL-c393t-cbe587960f630a56d6466de6e6bbe8c6b87099c57110e9b27a62c2fbe1f56ffc3</cites><orcidid>0000-0001-5277-9296 ; 0000-0003-4604-9355</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2425668479?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32305220$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Kartik R.</creatorcontrib><creatorcontrib>Mandleywala, Swati N.</creatorcontrib><creatorcontrib>Madias, Christopher</creatorcontrib><creatorcontrib>Weinstock, Jonathan</creatorcontrib><creatorcontrib>Rowin, Ethan J.</creatorcontrib><creatorcontrib>Maron, Barry J</creatorcontrib><creatorcontrib>Maron, Martin S.</creatorcontrib><creatorcontrib>Link, Mark S.</creatorcontrib><title>Single Coil Implantable Cardioverter Defibrillator Leads in Patients With Hypertrophic Cardiomyopathy</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Patients with hypertrophic cardiomyopathy (HC) may require higher energies to terminate ventricular fibrillation (VF); thus, dual coil defibrillation leads are often implanted. However, single coil leads may be preferred in young patients. All patients with HCM implanted with a transvenous ICD from years 2000 to 2014 were included. Of 249 patients, 223 underwent VF testing including 150 with a dual coil lead and 73 a single coil. Patients tested with dual coil compared with single coil had lower successful VF energies (15.7 ± 6.1 joule to 20.2 ± 7.9 joule (p <0.0001)). Adequate safety margin for defibrillation was noted in 97.3% of patients. Notably, 6 (4 with single coil leads) had inadequate safety margins (defined as ≥10 joule). Three of these 6 patients required replacement of a single coil lead with a dual coil lead. The remaining 3 underwent waveform tilt alteration, higher energy ICD, or removal of the can from the shock vector. There were no clinical or implant predictors of inadequate safety margins. In follow-up of 16 ± 30 months (range 0 to 170), there were 24 arrhythmias including 13 VF, all successfully terminated. In conclusion, in HC patients undergoing ICD implantation, single coil leads can provide adequate safety margins. In conclusion, defibrillation testing should be considered in all HC patients undergoing ICD implantation, and should be performed in those undergoing implantation with a single coil lead.</description><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Defibrillators</subject><subject>Ejection fraction</subject><subject>Failure</subject><subject>Fibrillation</subject><subject>Implantation</subject><subject>Patients</subject><subject>Safety</subject><subject>Safety margins</subject><subject>Transplants & implants</subject><subject>Ventricle</subject><subject>Ventricular fibrillation</subject><subject>Waveforms</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU1r3DAYhEVoSbZpf0KKoZdc7OrDklenEjZpElhoICk9Ckl-nZWxLUfSBvbfR8tueuilJyHxzGiYQeiC4IpgIr73lR57q0NbUUxxhVmFCTlBC7JsZEkkYR_QAmNMS0lqeYY-xdjnKyFcnKIzRhnmlOIFgkc3PQ9QrLwbivtxHvSUtNk_ZGvnXyEkCMU1dM4ENww6-VCsQbexcFPxoJODKcXij0ub4m43Zzr4eePsUT7u_KzTZvcZfez0EOHL8TxHv3_ePK3uyvWv2_vV1bq0TLJUWgM8xxe4EwxrLlpRC9GCAGEMLK0wywZLaXlDCAZpaKMFtbQzQDouus6yc3R58J2Df9lCTGp00ULOPYHfRkWZpHXTkIZn9Ns_aO-3YcrpFK0pF2JZNzJT_EDZ4GMM0Kk5uFGHnSJY7XdQvTruoPY7KMxULjnrvh7dt2aE9q_qvfgM_DgAkOt4dRBUtLlLC60LYJNqvfvPF28roJxy</recordid><startdate>20200615</startdate><enddate>20200615</enddate><creator>Kumar, Kartik R.</creator><creator>Mandleywala, Swati N.</creator><creator>Madias, Christopher</creator><creator>Weinstock, Jonathan</creator><creator>Rowin, Ethan J.</creator><creator>Maron, Barry J</creator><creator>Maron, Martin S.</creator><creator>Link, Mark S.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5277-9296</orcidid><orcidid>https://orcid.org/0000-0003-4604-9355</orcidid></search><sort><creationdate>20200615</creationdate><title>Single Coil Implantable Cardioverter Defibrillator Leads in Patients With Hypertrophic Cardiomyopathy</title><author>Kumar, Kartik R. ; 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thus, dual coil defibrillation leads are often implanted. However, single coil leads may be preferred in young patients. All patients with HCM implanted with a transvenous ICD from years 2000 to 2014 were included. Of 249 patients, 223 underwent VF testing including 150 with a dual coil lead and 73 a single coil. Patients tested with dual coil compared with single coil had lower successful VF energies (15.7 ± 6.1 joule to 20.2 ± 7.9 joule (p <0.0001)). Adequate safety margin for defibrillation was noted in 97.3% of patients. Notably, 6 (4 with single coil leads) had inadequate safety margins (defined as ≥10 joule). Three of these 6 patients required replacement of a single coil lead with a dual coil lead. The remaining 3 underwent waveform tilt alteration, higher energy ICD, or removal of the can from the shock vector. There were no clinical or implant predictors of inadequate safety margins. In follow-up of 16 ± 30 months (range 0 to 170), there were 24 arrhythmias including 13 VF, all successfully terminated. In conclusion, in HC patients undergoing ICD implantation, single coil leads can provide adequate safety margins. In conclusion, defibrillation testing should be considered in all HC patients undergoing ICD implantation, and should be performed in those undergoing implantation with a single coil lead.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32305220</pmid><doi>10.1016/j.amjcard.2020.03.011</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-5277-9296</orcidid><orcidid>https://orcid.org/0000-0003-4604-9355</orcidid></addata></record> |
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| subjects | Cardiac arrhythmia Cardiomyopathy Defibrillators Ejection fraction Failure Fibrillation Implantation Patients Safety Safety margins Transplants & implants Ventricle Ventricular fibrillation Waveforms |
| title | Single Coil Implantable Cardioverter Defibrillator Leads in Patients With Hypertrophic Cardiomyopathy |
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