IS Case 590: Abdominal cardioverter- defibrillator

Sirisha Jasti, MD

Imaging Sciences URMC


Imaging Sciences URMC 2010
Publication Date: 2011-11-17

History

Patient is a 56-year-old male status post-abdominal implantable cardioverter-defibrillator (ICD) placement.

Findings

Single AP view of the abdomen showed an ICD overlying the left lower quadrant of the abdomen

Diagnosis

Abdominal cardioverter- defibrillator

Discussion

An implantable cardioverter-defibrillator (ICD) is a device that has a pulse generator with leads that connect the pulse generator to the heart. The pulse generator is place in the subcutaneous tissues of the chest or abdomen and the leads are tunneled through a vein into the right heart. It is used in patients with recurrent ventricular tachycardia or ventricular fibrillation. The device monitors heart rhythm and paces or shocks the heart when an abnormal rhythm is identified, to restore the normal rhythm of the heart.

The subclavian approach is most commonly used for the implantation of an ICD with pulse generator placed in the subcutaneous tissues of the chest. However, in certain situations like poor vascular access through the subclavian or contraindication of pectoral placement due to infection, a transiliac approach is used for implanting the ICD. In such cases, the leads were inserted through the iliac vein and the pulse generator is placed in the upper quadrants of the abdomen.

References

  1. Giudici MC, Augelli NV, Longo CA, Meierbachtol CJ. Endovascular bi-ventricular pacing-defibrillator placement using a trans-atrial approach. J Interv Card Electrophysiol. 2010 Mar;27(2):143-5. PMID: 19543961

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