{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:02:00Z","timestamp":1780527720104,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>We describe the first successful implantation of an extravascular implantable cardioverter\u2010defibrillator (EV\u2010ICD) performed under local anesthetic with nurse\u2010led sedation, without the use of propofol or anesthetic support. The procedure was well tolerated in a carefully selected, motivated patient. Although this is a single case, the patient's experience and procedural metrics were comparable to those performed under general anesthesia. This approach may offer a safe and resource\u2010efficient alternative for individuals for whom general anesthesia is high risk or unavailable. It marks a potential shift in practice, mirroring transitions in S\u2010ICD implantation, which expanded to include nerve block, local anesthesia, and sedation.<\/jats:p>","DOI":"10.1111\/pace.70054","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T09:37:47Z","timestamp":1758015467000},"page":"1203-1207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolution of Extravascular ICD Implantation: Shift Toward Local Anesthesia and Nurse\u2010Led Sedation Without Propofol"],"prefix":"10.1111","volume":"48","author":[{"given":"Andre","family":"Briosa e Gala","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital Southampton NHS Foundation Trust Southampton UK"},{"name":"Human Development and Health University of Southampton Southampton 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