A new kind of extravascular implantable cardioverter defibrillator, with the help of a lead placed behind the sternum demonstrated safety and effectiveness goals for participants in a clinical study. The device effectively put an end to chronic and acute life-threatening ventricular arrhythmias.

The findings are published in The New England Journal of Medicine.

Clinically, arrhythmias such as ventricular tachycardia and ventricular fibrillation occur in the lower heart chambers, or ventricles. Arrhythmias are risky because they interfere with normal coordinated synchronized filling and pumping of blood from the heart. The condition can cause an individual to collapse, and even cause death if not treated in time. For high risk patients of ventricular arrhythmias, implantable cardioverter defibrillator accurately detects and terminates the condition, and thus saves lives.

For participants of the study, the lead of the new device was pushed under the sternum, compared to leads of transvenous ICDs that are pushed through the veins into the heart, or leads of subcutaneous ICDs that are placed beneath the skin above the sternum. Participants for the study did not include patients with prior open-heart surgery, or who required pacing to control the heart rate or required a pacemaker.

Importantly, development of the device is encouraging. The placing of lead in the new position behind the sternum, avoids uncommon but serious conditions associated with transvenous ICDs, such as damage to heart valves and lung collapse. The new device overcomes limitations of subcutaneous ICDs.

Meanwhile, due to position of the lead behind the sternum and close to the heart, it helps to deliver pacing, and with a longer battery life energy requirement is less for defibrillation than with subcutaneous ICD, stated the first author of the study.

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