Implantation: Pre-operative Evaluation to Discharge

  • Wolfram Grimm
  • Francis E. Marchlinski
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 188)


THOROUGH preimplant evaluation of the patient’s physical condition and arrhythmias is crucial to successful ICD implantation and long-term clinical efficacy of the implanted device. The first approved devices in the United States used epi-cardial lead systems which have demonstrated long-term stability of the defibrillation threshold (DFT).1,2 The less invasive nonthora-cotomy lead system approach, however, appears to result in a significantly lower perioperative morbidity and mortality with an excellent short-term clinical efficacy.3, 4, 5 Since nonthoracotomy lead systems can be implanted in virtually all patients when biphasic shock waveforms are being used3 with similar low intraoperative DFTs as compared to what has been reported for conventional epi-cardial lead systems with monophasic shock waveforms, the nonthoracotomy approach has already become the primary method of ICD implantation.


Implantable Cardioverter Defibrillator Lead System Defibrillation Threshold Biphasic Waveform Transvenous Lead 
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Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Wolfram Grimm
  • Francis E. Marchlinski

There are no affiliations available

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