Poland's first procedure to implant an extravascular defibrillator-cardioverter defibrillator

A cardioverter-defibrillator is a small electronic device designed to recognize life-threatening arrhythmias and perform appropriate intervention to terminate them. It consists of intracardiac electrodes and a battery-powered electronic module connected to them.

- In the traditional transvenous form of the device, electrodes are inserted into the heart cavities through the venous system under X-ray guidance. In the extravascular system, the device's electrode is placed under the sternum, closer to the heart - without interfering with the cardiovascular system. As a result, in addition to interrupting a potential arrhythmia with defibrillation, it is also possible to use so-called antiarrhythmic pacing, which is better tolerated by patients , said Dr. Pawel Syska, the first operator.

According to the cardiologist, the use of the EV-ICD system, as in the case of fully subcutaneous implantable cardioverter-defibrillators implanted at the National Institute of Cardiology, makes it possible to avoid the insertion of electrodes into the heart and vascular system, which significantly reduces the risk of serious complications, especially long-term ones - associated with the long-term presence of electrodes in the venous system and in the heart.

- We performed the procedure to implant the EV-ICD device in a young patient with a very high risk of sudden cardiac death and significant limitations to the use of other previously available types of cardioverter-defibrillators. Our patient awaited this procedure with high hopes of returning to a normal and safe life. All indications are that his dream will soon come true," said Prof. Maciej Sterlinski, deputy director for clinical affairs at the National Institute of Cardiology.

At the same time, the procedure is the first of its kind performed in Poland due to clinical indications. However, already in 2020-2021, a team of specialists from the National Institute of Cardiology, led by Prof. Maciej Sterlinski, performed 13 such procedures as part of the international EV ICD Pivotal Trial research project. Along with many recognized European and American centers, NIKard was then the only Polish research center participating in this prestigious project.

- As a team, we constantly set ourselves new goals and challenges. Our ambition is that NIKard - our clinical and research center - will all the time be at the global forefront of implementing the latest, effective and safe treatments for cardiovascular diseases. The experience we have accumulated allows us to help a growing number of patients, as exemplified by today's procedure. This is how we see our mission," added Prof. Maciej Sterlinski.

As he himself emphasized, the participation of the National Institute of Cardiology in the EV ICD Pivotal Trial project, as well as NIKard's previous scientific and implementation experience in this area, would not have been possible without the widely recognized worldwide participation of other Polish teams, including the Krakow team under the direction of Prof. J. Lelakowski and the Zabrze team under the direction of Prof. Z. Kalarus - in the pilot phases of research on minimally invasive subcostal access.

- This shows how joint commitment, systematic education and cooperation are important to provide our patients with the best possible treatment," conclude Prof. M. Sterlinski and Dr. P. Syska.

Source: press release