Subcutaneous Implantable Cardioverter Defibrillator: Early Experience.

Introduction: The implantable cardioverter defibrillator had been increasing the survival of patients at high risk for sudden cardiac death. The subcutaneous implantable cardioverter defibrillator was developed to mitigate the complications inherent to lead placement into cardiovascular system.

Objective: To report the initial experience of 18 consecutive cases of subcutaneous implantable cardioverter defibrillator implantation showing the indications, potential pitfalls and perioperative complications.

[Echocardiographic assessment of cardiac resynchronization therapy: two-year follow-up period].

Background: The cardiac resynchronization therapy (CRT) is an effective option for patients with advanced heart failure (HF). Clinical, electrocardiographic and echocardiographic criteria have been studied in an attempt to find the patients that will benefit from the CRT, considering that the echocardiogram is the method that is used both in the selection and in the assessment of such therapy.

Objective: The objective of this work is to analyze the use of echocardiogram to assess the CRT, in a ten-day follow-up period and after two years of evolution.

[Technical aspects of coronary sinus catheterization based on the atrial component of the intracavitary electrogram and radiological anatomy during the implantation procedure of a biventricular pacemaker].

Objective: To present a technical proposal based on the experience of 130 implantations using a simplified technique for coronary sinus catheterization, based on the atrial component of the intracavitary electrogram and radiological anatomy.

Methods: From October, 2001 to October, 2004, 130 biventricular pacemaker implantations were performed, using radiological anatomy and observation of the intracavitary electrogram, focusing on the atrial component.

Results: The implantation of the system using left ventricular pacing via coronary sinus was not possible in 8 patients.

Ventricular resynchronization through biventricular cardiac pacing for the treatment of refractory heart failure in dilated cardiomyopathy.

Objective: The biventricular pacing (BVP) approach has good results in the treatment of congestive heart failure (CHF) in patients (pts) with disorders of intraventricular conduction.

Methods: We have applied BVP to 28 pts, with left ventricular pacing using minitoracotomy in 3 pts and the transvenous approach via coronary sinus in 25 pts. The mean duration of the QRS complexes was 187 ms, in the presence of the left branch block in 22 pts, and right branch block + divisional hemiblock in 6 pts.