An implantable cardioverter defibrillator (ICD) detects and interrupts life-threatening cardiac dysrhythmia incidents. By default, ICD electrodes are inserted in the heart via the patient’s venous system, yet this particular patient could not be approached with this conventional method because of the presence of AV fistulas for dialysis. For this reason, extravascular mode was elected. – In the extravascular variant, the electrode is implanted under the sternum to the area directly adjacent to the heart, bypassing the veins – prof. Marcin Grabowski, head of the First Department and Clinic of Cardiology at UCK WUM, explains. He further emphasizes that with the new method, the electrode can be positioned near the heart and as a result so-called antitachyarrhythmic stimulation is possible, which is better tolerated by patients than high energy discharges.
The procedure was conducted on November 15 by a team of operating surgeons from the First Department and Clinic of Cardiology at UCK WUM, with the following members: Marcin Michalak, MD, and Łukasz Januszkiewicz, MD, together with nurses: Dorota Świątek, Elżbieta Świętoń and Oleksandra Solohub, and a radiation therapy specialist Katarzyna Zawiła. The procedure was done with the support of prof. Mariusz Kuśmierczyk, cardiac surgeon from the Cardiac Surgery, Thoracic Surgery and Transplantology Clinical Department. The patient was anesthetized by Maciej Michałowski, MD, with his team.
It was the second implantation of this type in Poland. The first procedure took place one day earlier at the Arrythmia Center of the National Institute of Cardiology.
