Publications by authors named "J C de Veld"
Uncomplicated Extravascular Implantable Cardioverter-Defibrillator Extraction After 4 Years Dwell Time: A Case Report.
J Cardiovasc Electrophysiol
December 2024
The extravascular implantable cardioverter-defibrillator (EV-ICD) was developed to overcome complications associated with transvenous leads while being able to deliver anti-tachycardia pacing (ATP). The lead is implanted in the substernal space, which makes extraction a cautious procedure. We present a case of a 51-year-old women with a successful EV-ICD extraction after a lead dwell time of 4 years, which is the longest reported.
View Article and Find Full Text PDFInappropriate Therapy and Shock Rates Between the Subcutaneous and Transvenous Implantable Cardiac Defibrillator: A Secondary Analysis of the PRAETORIAN Trial.
Circ Arrhythm Electrophysiol
December 2024
Article Synopsis
- Inappropriate therapy (IAT) is a significant issue associated with implantable cardiac defibrillator (ICD) therapy, particularly highlighted in early subcutaneous ICD (S-ICD) studies which showed high rates of inappropriate shocks (IAS).
- The PRAETORIAN trial, an international study with 849 patients, found no major differences in IAT and IAS rates between S-ICD and transvenous ICD (TV-ICD) groups, as both groups had similar cumulative incidences.
- Key predictors for IAT varied between the two groups, with TV-ICD patients experiencing IAT mainly from supraventricular tachycardias, while S-ICD patients faced issues from cardiac oversensing
Article Synopsis
- The S-ICD was created to eliminate lead-related issues found in the TV-ICD, as it is an external device that sits under the skin rather than using leads inside the body.
- This analysis comes from the PRAETORIAN trial, where patients were randomly assigned to either S-ICD or TV-ICD and assessed for quality of life through various questionnaires at different stages.
- Results showed no significant differences in physical and mental well-being between the groups, but patients who experienced a shock recently reported lower social functioning and emotional health compared to those who did not.
Background: The PRAETORIAN score was developed as an alternative for defibrillation testing after subcutaneous implantable cardioverter-defibrillator implantation to assess 3 aspects of implant position on a bidirectional chest radiograph. The score is validated on a standard standing chest radiograph with arms elevated in the lateral view.
Objective: We aimed to evaluate the effect of different anatomic positions on the PRAETORIAN score.
The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as a feasible alternative to the transvenous ICD in the treatment of ventricular tachyarrhythmias in patients without indications for pacing or cardiac resynchronization therapy. Since its introduction, numerous innovations have been made and clinical experience has been gained, leading to its adoption in current practice and preference in certain populations. Moreover, emerging technologies like the extravascular ICD and the combination of the S-ICD with the leadless pacemaker offer new possibilities for the future.
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