A SUBCUTANEOUS LEAD ARRAY FOR IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS

Two patients received an implantable cardioverter defibrillator with the combination of a transvenous lead and a subcutaneous lead array with three branches. This approach allowed us to find low defibrillation thresholds in both patients (less-than-or-equal-to 10 and less-than-or-equal-to 15 joules [J], respectively), which was impossible with a transvenous catheter. In a third patient, a crinkled subcutaneous patch was replaced by an array. The defibrillation threshold with the array was less-than-or-equal-to 20 J, as opposed to > 24 J with the patch. No surgical problems occurred. The subcutaneous array is a technical improvement for the therapy with implantable defibrillators, when a single catheter system is not sufficient to ensure a safety margin for defibrillation, or when surgical or postsurgical problems occur with a subcutaneous patch.