Initial Clinical Experience with a New Small Sized Third‐Generation Implantable Cardioverter Defibrillator: Results of a Multicenter Study

Abstract

This study reports the acute clinical experience with the new CPI VENTAK MINI: a small sized (68 cc), implantable cardioverter defibrillator (ICD) with 33 J stored energy. Implantation of the device was attempted in 113 patients (90 men, mean age 57 ± 16 years, 64 with coronary artery disease, mean left ventricular ejection fraction 41%) with ventricular tachycardia or ventricular fibrillation (VF). All 113 patients (100%) were ultimately implanted, 12% of them for ICD replacement. Transvenous lead implantation was accomplished in all 104 patients (100%) receiving new leads, 95% of them with a single lead configuration. The safety criteria for implantation (2 consecutive VF conversions at 15 J or 3 at 20 J. in both cases without failures to convert) were demonstrated in all but 7 patients (6%). In 6 of these, safety criteria were not fully assessed while in the last patient defibriliation efficacy was not determined. Of the 104 patients with new leads, 90% underwent pectoral implantation. Of the 9 patients (9%) abdominally implanted, only 4 (4%) (3 children) were judged small sized for pectoral implant. At predischarge testing, reliable VF detection and conversion were noted in 96 of 97 patients tested. There was no perioperative mortality. At a 3.6 ± 1.3 months follow‐up, 34% of the patients had a spontaneous arrhythmic event, and 24% of the patients received shocks. Clinically inappropriate therapies occurred in 8% of the episodes in which any kind of therapy was delivered. This study demonstrates the short‐term clinical efficacy and safety of the new device, and that pectoral implantation can be performed in the large majority of patients.

Keywords

Affiliated Institutions

• Cardiovascular Research Center BR

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