Electrode of a subcutaneous implantable cardioverter-defibrillator (ultrasound)

Case contributed by Giorgio M Baratelli

Presentation

Screening breast ultrasound.

Patient Data

Age: 40 years
Gender: Female

A hyperechoic moderately oval line of 3-4 mm, with a posterior sharp acoustic shadow, detected in the left parasternal region is the distal portion of the subcutaneous electrode of a subcutaneous implantable cardioverter-defibrillator (S-ICD).

The lateral view of the patient shows the surgical scar and the cardioverter-defibrillator (outlined by pen), placed in a subcutaneous pocket in the left lateral thoracic region, just below the axilla.

The diagram shows the cardioverter-defibrillator in the left lateral thoracic region, just below the axilla, and the subcutaneous electrode; the horizontal tract is tunneled in the inframammary fold and the vertical tract is parallel to the left sternal border, approximately 1-2 centimeters from the sternal border.

Case Discussion

The S-ICD System reveals cardiac activity and, if necessary, delivers defibrillation therapy. The vertical track of the subcutaneous electrode of the S-ICD (diameter of 9 French) is implanted parallel to the left sternal border, approximately 1-2 centimeters from the sternal border, in close proximity to the deep fascia, below adipose tissue of the subcutaneous layer. The electrode is made metallic and of polycarbonate polyurethane, for insulation.

Disclosure: I, Giorgio M Baratelli, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.

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