Jg. Kall et al., IMPLANTATION OF A SUBCUTANEOUS LEAD ARRAY IN COMBINATION WITH A TRANSVENOUS DEFIBRILLATION ELECTRODE VIA A SINGLE INFRACLAVICULAR INCISION, PACE, 18(3), 1995, pp. 482-485
Occasional patients have excessive defibrillation energy requirements
despite appropriate transvenous defibrillation lead position and modif
ication of defibrillation waveform and configuration. Preliminary data
suggest that use of subcutaneous defibrillation electrode arrays with
nonthoracotomy systems is associated with a substantial reduction in
defibrillation threshold. The current operative approach to subcutaneo
us lead array implantation involves the use of a separate left chest i
ncision. We present two cases in which implantation of a subcutaneous
lead array in combination with a transvenous defibrillation electrode
was performed via a single infraclavicular incision and associated wit
h a reduction in defibrillation threshold. Such an approach simplities
implantation and avoids the potential morbidity of the additional inc
ision required of a left interal chest approach.