Cardiac electrophysiologists have been placing implantable cardioverter defibrillators (ICDs) for many years, with the standard system using a transvenous device. Although small, the device required physicians to implant directly into the heart and used leads with limited durability. Several years ago, subcutaneous implantable cardioverter defibrillators (S-ICDs) were introduced, but the first generation S-ICD was largely restricted to adult patients, due to its size and the lack of remote monitoring capability. A newer, smaller model of the device was released in summer 2015, allowing pediatric electrophysiologists at Penn State Children’s Hospital to implant this device in children.
This second-generation device is smaller and thinner, projected to last 40 percent longer than the previous version and is enabled for remote patient monitoring. It eliminates many of the potential complications associated with transvenous leads and has demonstrated excellent real-world results, including low complication rates and high conversion efficacy.1,2 “The smaller size and remote monitoring capability of the second-generation S-ICD have made it more compatible for our patient population, and we do not have to implant anything directly into the heart,” says Jason R. Imundo, MD, pediatric cardiologist and electrophysiologist, Penn State Children’s Heart Group. Instead, the device is implanted just under the skin near the ribs. Continue reading