SAFETY, FEASIBILITY AND LONG-TERM FOLLOW-UP OF A NON-THORACOTOMY DEFIBRILLATION SYSTEMIN PATIENTS WITH INDUCIBLE SUSTAINED VENTRICULAR TACHYCARDIA FIBRILLATION/

A non-thoracotomy lead system CPI-ENDOTAK, a transvenous lead used alo ne or combined with a subcutaneous patch (SQ-P), was evaluated as an a lternative to epicardial patches/electrodes in patients at high risk f or sudden cardiac death undergoing implantable cardioverter-defibrilla tor (ICD) surgery. Fifty nine patients, 62 +/- 11.4 years with CAD (83 .0%) cardiomyopathy (11.9%) other (5.1%), mean ejection fraction 31.8 +/- 14%, with inducible sustained VT/VF underwent testing of either le ad alone or lead/SQ-P. Four configurations of NTL were tested. Fifty o ne patients had NTL implanted (lead alone = 60.8% and lead/SQ-P = 39.2 %). Eight patients required non-NTL approaches, due to high DFT (7) or anatomic anomaly (1). DFT's were 19.1J (lead alone) and 20.8J (lead/S Q-P); Acute complications: pulmonary embolism 1, lead dislodgement 3, sensing malfunction 1. [GRAPHICS] Conclusion: A NTL system using eithe r a single transvenous lead alone or combined with SQ-P can be implant ed successfully in high risk patients with a low incidence of acute co mplications. Non-arrhythmic survival is lowest in patients receiving d efibrillation shocks. Arrhythmic survival is high in all patients.