Successful extravascular implantable cardioverter defibrillator implantation in a patient with ankylosing spondylitis and severe thoracic deformity: a case report.
- 1Department of Cardiology, the Second Xiangya Hospital of Central South University, middle Ren-Min road No.139, Changsha, Hunan 410011, PR China.
- 2Medtronic(Shanghai) Management Co., Ltd.
Abstract
Background
Severe thoracic deformity in ankylosing spondylitis (AS) can complicate implantable cardioverter defibrillator (ICD) implantation and device selection. Substernal EV-ICD implantation requires careful anatomical assessment and individualized procedural planning.Case summary
A 57-year-old male with severe AS and dilated cardiomyopathy was referred for primary prevention ICD implantation. Given the high complication risks associated with conventional approaches, EV-ICD was selected. A tailored positioning strategy was employed to accommodate the thoracic deformity. Intraoperative resistance during substernal dissection was successfully overcome through meticulous re-dissection. Favourable intraoperative electrical parameters were obtained, including an R-wave sensing amplitude of 5.6 mV without P-wave oversensing and successful defibrillation at 30 J on the first attempt. At 6-month follow-up, device performance remained stable without sensing anomalies or inappropriate shocks.Discussion
This case demonstrates the technical feasibility of EV-ICD implantation in a carefully selected patient with severe AS-associated thoracic deformity. Preoperative CT assessment, tailored patient positioning, careful dissection, and surgical backup enabled successful implantation and stable device performance during 6 months of follow-up.
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BibTeX
@article{he2026successful,
title = {{Successful extravascular implantable cardioverter defibrillator implantation in a patient with ankylosing spondylitis and severe thoracic deformity: a case report.}},
author = {Jia He and Qiming Liu and Zean Zhu and Zhenjiang Liu and Zhihong Wu},
journal = {European heart journal. Case reports},
year = {2026},
month = oct,
doi = {10.1093/ehjcr/ytag758},
url = {https://europepmc.org/article/MED/42924249},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Successful extravascular implantable cardioverter defibrillator implantation in a patient with ankylosing spondylitis and severe thoracic deformity: a case report.
AU - Jia He
AU - Qiming Liu
AU - Zean Zhu
AU - Zhenjiang Liu
AU - Zhihong Wu
PY - 2026
DA - 2026/10/15
JO - European heart journal. Case reports
DO - 10.1093/ehjcr/ytag758
UR - https://europepmc.org/article/MED/42924249
AB - Background Severe thoracic deformity in ankylosing spondylitis (AS) can complicate implantable cardioverter defibrillator (ICD) implantation and device selection. Substernal EV-ICD implantation requires careful anatomical assessment and individualized procedural planning.Case summary A 57-year-old male with severe AS and dilated cardiomyopathy was referred for primary prevention ICD implantation. Given the high complication risks associated with conventional approaches, EV-ICD was selected. A tailored positioning strategy was employed to accommodate the thoracic deformity. Intraoperative resistance during substernal dissection was successfully overcome through meticulous re-dissection. Favourable intraoperative electrical parameters were obtained, including an R-wave sensing amplitude of 5.6 mV without P-wave oversensing and successful defibrillation at 30 J on the first attempt. At 6-month follow-up, device performance remained stable without sensing anomalies or inappropriate shocks.Discussion This case demonstrates the technical feasibility of EV-ICD implantation in a carefully selected patient with severe AS-associated thoracic deformity. Preoperative CT assessment, tailored patient positioning, careful dissection, and surgical backup enabled successful implantation and stable device performance during 6 months of follow-up.
SN - 2514-2119
ER -