Novel Use of a Vascular Plug to Anchor an Azygous Vein ICD Lead

作者：Bar Cohen Yaniv^*; Takao Cheryl M; Wells Winfield J; Saxon Leslie A; Cesario David A; Silka Michael J

来源：Journal of Cardiovascular Electrophysiology, 2010, 21(1): 99-102.

DOI：10.1111/j.1540-8167.2009.01510.x

• ICD
• hypertrophic cardiomyopathy
• high defibrillation thresholds
• cardiac arrest

Vascular Plug for ICD Lead. We describe the case of a young patient with severe hypertrophic cardiomyopathy and marginal defibrillation thresholds (DFTs) at implant of a standard transvenous implantable cardioverter-defibrillator (ICD) system. The patient subsequently experienced multiple failed ICD shocks during a prolonged episode of spontaneous ventricular tachycardia/fibrillation. Placement of a second single-coil shocking lead in the azygous vein resulted in acceptable DFTs, but the new lead migrated superiorly within hours of the procedure. To stabilize the lead position, a vascular plug was placed in the distal azygous vein, and the shocking lead screw was actively fixated to the meshwork of the device. Subsequent testing confirmed both adequate defibrillation and stable lead position. (J Cardiovasc Electrophysiol, Vol. 21, pp. 99-102, January 2010).

• 出版日期2010-1