Subcutaneous defibrillator use with unipolar pacemakers: Cautiously possible

Matanyahu Rubinstein; Angela Zhu; Justin A Mariani; Hitesh C Patel

doi:10.1016/j.ipej.2023.05.002

Subcutaneous defibrillator use with unipolar pacemakers: Cautiously possible

Indian Pacing Electrophysiol J. 2023 Jul-Aug;23(4):126-129. doi: 10.1016/j.ipej.2023.05.002. Epub 2023 May 18.

Authors

Matanyahu Rubinstein¹, Angela Zhu¹, Justin A Mariani², Hitesh C Patel³

Affiliations

¹ Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia.
² Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia; Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Central Clinical School, Monash University, Melbourne, Australia.
³ Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia; Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Central Clinical School, Monash University, Melbourne, Australia. Electronic address: dochiteshpatel@hotmail.com.

Abstract

Implantation of subcutaneous implantable cardioverter-defibrillator in a patient with existing unipolar pacemaker is against manufacturer recommendations. We report the case of a successful subcutaneous implantable cardioverter-defibrillator implantation in a patient with Fontan circulation and concomitant active unipolar pacing and present a summary of recommendations when considering subcutaneous implantable cardioverter-defibrillator implantation with unipolar pacing. Recommendations included: pre-procedure screening, rescreening during implantation and ventricular fibrillation induction, pacemaker programming, and post-procedure investigations.

Keywords: Congenital heart disease; Fontan circulation; Subcutaneous implantable cardioverter-defibrillator; Unipolar epicardial pacemaker.

Publication types

Case Reports