Abdominal submuscular implant of subcutaneous implantable cardioverter-defibrillator in a young child

Abstract

We describe the abdominal submuscular implant of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in a 4-year-old girl (20 kg) with aborted ventricular fibrillation cardiac arrest. With parental wish, S-ICD was chosen to be implanted after detailed discussion. The abdominal pocket was created between the external oblique and internal oblique muscle layers, over the left side of her abdomen. Using 3-incision technique, the electrode coil was implanted with the use of tunnelling device. The coil was placed with a slack subcutaneously over the sternum, as illustrated in the radiograph shown in Figure. Defibrillation threshold testing successfully passed. Two-month post implantation she had an episode of ventricular tachycardia successfully cardioverted by ICD shock.