A Subcutaneous Lead Array for Implantable Cardioverter Defibrillators

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Abstract
Two patients received an implantable cardioverter defibrillator with the combination of a transvenous lead and a subcutaneous lead array with three branches. This approach allowed us to find low defibrillation threshoids in both patients (≤10 and ≤ 15 joules [J], respectively], which was impossible with a transvenous catheter. In a third patient, a crinkled subcutaneous patch was replaced by an array. The defibrillation threshoid with the array was ≤ 20 J, as opposed to ≤24 J with the patch. No surgical problems occurred. The subcutaneous array is a technical improvement for tiie therapy with impiantable defibrillators, when a single catheter system is not sufficient to ensure a safety margin for defibrillation, or when surgicai or postsurgical problems occur with a subcutaneous patch.