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World’s First Subcutaneous ICD Treats Cardiac Arrest without Touching the Heart

Posted: Apr. 2, 2014

A breakthrough treatment alternative to the traditional implantable cardio-defibrillator (ICD) provides patients at risk for sudden cardiac arrest (SCA) with the same potentially-lifesaving protection, but without touching the heart.

Lawrence Kanner, MD, FACC, director of electrophysiology and arrhythmia services at South Nassau Communities Hospital, recently implanted the S-ICD® System, the world’s first and only implantable cardioverter-defibrillator that functions without leads (also known as electrodes – the thin, insulated wires attached to a typical ICD) placed into the heart.

The S-ICD System provides defibrillation therapy for the treatment of life-threatening rapid heart rhythms in patients who do not require pacemaker support and whose rapid heart rhythms are not reliably terminated with pacing.

SCA is an abrupt loss of heart function. Most episodes are caused by a rapid and/or chaotic heart beat or ventricular fibrillation (the uncoordinated contraction of the cardiac muscle of the ventricles of the heart). Recent estimates show that approximately 850,000 people in the United States are at risk of SCA and would benefit from an ICD device, but remain unprotected. Each year, SCA claims the lives of up to 460,000 people in the U.S. alone, and more people die from it than from lung cancer, breast cancer and AIDS combined.

“ICDs and CRT-Ds have been proven in clinical studies to save and extend lives by preventing sudden cardiac death (SCD) and treating heart failure,” added Dr. Kanner.

The S-ICD System has two main components: (1) the generator, which powers the system, monitors heart activity, and delivers a shock if needed, and (2) the electrode, which enables the device to sense the cardiac rhythm and deliver shocks when necessary. Both components are implanted just under the skin—the generator at the side of the chest, and the electrode beside the breastbone. Unlike traditional transvenous ICDs, which are inserted through a vein, the heart and blood vessels remain untouched with the S-ICD system. Implantation with the S-ICD System is straightforward, using anatomical landmarks, and does not require fluoroscopy (an x-ray procedure that makes it possible to see internal organs in motion). Fluoroscopy is required for implanting the leads attached to typical transvenous ICD systems.

Dr. Kanner and South Nassau’s Center for Cardiovascular Health have been in the forefront in providing heart failure patients on Long Island with the latest advancements in ICD devices and electrophysiology services. Dr. Kanner was the first electrophysiologist on Long Island to implant several groundbreaking cardiac devices: the Viva® cardiac resynchronization therapy device with defibrillation (CRT-D) (which continuously adjusts to individual patient needs and preserves each patient’s normal heart rhythms; Incepta® ICD (recognized as the world’s smallest and thinnest ICD); Evia® pacemaker (which incorporates a wireless monitoring system that immediately notifies the patient’s physician if the patient or the pacemaker is experiencing complications) and was among the first to implant the Revo MRI™ SureScan® pacing system (the first pacemaker in the U.S. specifically designed for use in a MRI environment).

In addition to ICDs, Dr. Kanner and electrophysiologists at the Center for Cardiovascular Health use an array of other advanced technologies and treatments to provide timely, accurate diagnoses and therapies for the range of cardiac arrhythmias. This includes diagnostic studies, defibrillator maintenance, implanting and testing of pacemakers, and radiofrequency catheter ablation.