Table 1.
Clinical characteristics of the patients, procedure times, fluoroscopy times and parameters obtained at implant and the make of the device.
| Case 1 | Case 2 | Case 3 | Case 4 | |
|---|---|---|---|---|
| Sex | M | M | M | F |
| Age | 49 | 79 | 80 | 77 |
| Ejection fraction (%) | 20 | 34 | 18 | 32 |
| Cardiomyopathy | Ischaemic | Ischaemic | Ischaemic | Non-ischaemic |
| Cardiac rhythm | Atrial fibrillation | Sinus rhythm | Sinus rhythm | Sinus rhythm |
| Bundle branch block | Right bundle branch block (QRS duration = 154 ms) | Bifascicular block (QRS duration = 164 ms) | Left bundle branch block (paced QRS duration = 174 ms) | Left bundle branch block (QRS duration = 164 ms) |
| Other features | AV node ablation after CRT–ICD implantation | Dual chamber pacemaker carrier before CRT–ICD implantation | ||
| Parameters obtained at implant | ||||
| RV-wave amplitude | 9.1 mV | 14.2 mV | 12.5 mV | 9.1 mV |
| RV lead impedance | 955 Ω at 5.0 V | 1156 Ω at 5.0 V | 738 Ω at 5.0 V | 656 Ω at 5.0 V |
| RV threshold | 0.4 V at 0.5 ms | 0.4 V at 0.5 ms | 0.4 V a 0.5 ms | 0.5 V at 0.5 ms |
| RV lead position | Apex | Apex | Mid-septum | Apex |
| P-wave amplitude | 0.9 ms | 3.1 mV | 3.5 mV | 2.2 mV |
| P lead impedance | not determined | 530 Ω at 5.0 V | 479 Ω at 5.0 V | 528 Ω at 5.0 V |
| P threshold | not determined | 1.2 V at 0.5 ms | 4.5 V at 1.6 ms | 1.3 V at 0.5 ms |
| LV-wave amplitude | 19.9 mV | 9.3 mV | 10.1 mV | 1.2 mV |
| LV impedance | 769 Ω at 5.0 V | 1308 Ω at 5.0 V | 1027 Ω at 5.0 V | 475 Ω at 5.0 V |
| LV threshold | 0.3 V at 0.5 ms | 2.0 V at 0.5 ms | 0.3 V at 0.5 ms | 1.9 V at 0.5 ms |
| Target vein for CS lead | Posterior vein | Anterior vein | Lateral vein | Lateral vein |
| LV lead postion | Distal | Distal | Proximal | Mid |
| Manufacturers of the ICD | Boston scientific livian REF H247 | Boston scientific livian REF H247 | Boston scientific livian REF H247 | Medtronic consulta D234TRK |
| Bipolar ICD lead | Guidant Endotak Reliance G REF 0175 (passive fixation, double coil) | Guidant Endotak Reliance G REF 0175 (passive fixation, double coil) | Guidant Endotak Reliance SG REF 0181 (active fixation, single coil) | Medtronic 6935 (active fixation, single coil) |
| Bipolar left lead | Guidant Easytrak 2 REF 4542 | Guidant Easytrak 2 REF 4543 | Guidant Easytrak 2 REF 4542 | Medtronic 4194 |
| Bipolar atrial lead | Guidant, Fineline 2 (passive fixation) REF 4480 | Guidant, Fineline 2 (passive fixation) REF 4480 | Medtronic 4592 (passive fixation) | Medtronic 5594 (passive fixation) |
| Total time for implantation (min) | 168 | 142 | 130 | 124 |
| Length of radiation exposure (DAP) | 16.8 min (2914 cGy×cm2) | 16.9 min (3984 cGy×cm2) | 7.3 min (3946 cGy×cm2) | 4.2 min (1089 cGy×cm2) |
AV, atrioventricular; RV, right ventricle; LV, left ventricle; CS, coronary sinus; CRT, cardiac resynchronization therapy; ICD, implantable cardioverter-defibrillator; DAP, dose area product.