Usefulness of lead repositioning from left to right sternal border for a patient with subcutaneous implantable cardioverter defibrillator showing high defibrillation threshold

对于皮下植入式心脏复律除颤器(ICD)患者,若其除颤阈值较高,则将导线从胸骨左侧缘移至右侧缘的有效性值得探讨。

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Abstract

A 62-year-old man with Brugada syndrome underwent subcutaneous implantable cardioverter defibrillator implantation. The lead was positioned along the left sternal border and defibrillation threshold (DFT) testing was performed. However, ventricular fibrillation (VF) was not terminated with 65 J and 80 J shocks. Shock impedance was 82 ohms. We repositioned the lead to the right sternal border and performed DFT testing again, followed by the VF termination with a 65 J shock. Shock impedance was 59 ohms. The positional relationship among the lead, generator, and heart was changed by lead repositioning, which may have contributed to improved shock impedance and DFT.

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