Pause-prevention pacing in an extravascular implantable cardioverter-defibrillator.

HeartRhythm Case Rep

Medtronic, Inc., Mounds View, Minnesota.

Published: November 2023


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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10667118PMC
http://dx.doi.org/10.1016/j.hrcr.2023.08.014DOI Listing

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Extravascular implantable cardioverter-defibrillators (EV-ICD) offer defibrillation, anti-tachycardia pacing (ATP), and backup pacing, packaged in a unit comparable to traditional transvenous ICDs in size, shape, and longevity. However, the pacing capabilities of EV-ICD are restricted to ATP, pause prevention and post-shock pacing. For EV-ICD patients who develop the need for pacing, having a concomitant leadless pacemaker such as Micra could provide the needed pacing support.

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Background: The extravascular implantable cardioverter-defibrillator (ICD) has a single lead implanted substernally to enable pause-prevention pacing, antitachycardia pacing, and defibrillation energy similar to that of transvenous ICDs. The safety and efficacy of extravascular ICDs are not yet known.

Methods: We conducted a prospective, single-group, nonrandomized, premarket global clinical study involving patients with a class I or IIa indication for an ICD, all of whom received an extravascular ICD system.

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