Newsroom Article

Parkview Heart Institute site of state's first subcutaneous implantable defibrillator procedure

Parkview Heart Institute Monday was the first hospital in Indiana and among the first in the country to implant the new Boston Scientific S-ICD® System, the world’s first and only commercially available subcutaneous implantable defibrillator (S-ICD). The recently FDA approved device establishes a new category of protection for patients at risk of sudden cardiac arrest. Parkview Heart Institute is the only site currently performing this procedure in the state because the Parkview Research Center was the only research facility in the state approved to participate in the clinical research trials. 

Michael J. Mirro, MD, and David E. Schleinkofer, MD, both with Parkview Physicians Group (PPG) – Cardiology, were the first in the state to perform the procedure. 

“There are a number of patients in need of a device like the S-ICD,” said Michael J. Mirro, MD, PPG – Cardiology. “Defibrillators as we’ve known them for many years work very well for most patients but those that have poor vascular access and younger patients will see a great benefit from this new treatment option.” 

Richard F. Otten, MD and Bradley A. Hardin, MD, also with PPG – Cardiology, are also approved to implant the device.  

The S-ICD System is designed to provide the same protection from sudden cardiac arrest as transvenous implantable cardioverter defibrillators (ICDs); however the S-ICD sits entirely just below the skin without the need for thin, insulated wires – known as electrodes or ‘leads’ – to be placed into the heart itself. This leaves the heart and blood vessels untouched, offering physicians and patients an alternative treatment to transvenous ICDs.  

Sudden cardiac arrest is an abrupt loss of heart function.  Most episodes are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia or ventricular fibrillation.  Recent estimates show that approximately 850,000 people in the United States are at risk of SCA and indicated for an ICD device, but remain unprotected.

The S-ICD System has two main components: (1) the pulse generator, which powers the system, monitors heart activity, and delivers a shock if needed, and (2) the electrode, which enables the device to sense the cardiac rhythm and deliver shocks when necessary.  Both components are implanted just under the skin—the generator at the side of the chest, and the electrode beside the breastbone.  Unlike transvenous ICDs, the heart and blood vessels remain untouched.  Implantation with the S-ICD System is straightforward using anatomical landmarks, without the need for fluoroscopy (an x-ray procedure that makes it possible to see internal organs in motion).  Fluoroscopy is required for implanting the leads attached to transvenous ICD systems.   

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