{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:44:46Z","timestamp":1789062286720,"version":"build-2803163510"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Subcutaneous implantable cardioverter defibrillators (S-ICDs) are an attractive alternative to transvenous ICDs among those not requiring pacing. However, the risks of damage to the S-ICD electrode during sternotomy and adverse interactions with sternal wires remain unclear. We sought to determine the rates of damage to the S-ICD lead during sternotomy, inappropriate shocks from electrical noise due to interaction with sternal wires, and failure to terminate spontaneous or induced ventricular arrhythmias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Retrospective, multicenter study of patients undergoing sternotomy before or after S-ICD implantation. Clinical, procedural, and device-related data were collected by each center and analyzed by the coordinating center. These data were compared with a historical control cohort of nonsternotomy patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Of 196 identified patients (52\u00b116 years, 47 women), 166 underwent S-ICD implantation after sternotomy and 30 sternotomy after S-ICD. There was no damage to any lead among those who underwent sternotomy after S-ICD. Defibrillation threshold testing was performed in 63% at implant, with 91% first shock success. During a median follow-up of 29 months (range, 1\u2013188), S-ICD first shocks successfully terminated spontaneous ventricular arrhythmias in 31 of 32 patients (97%). Inappropriate shocks occurred in 22 patients, most commonly related to T wave oversensing (n=14). Compared with the nonsternotomy controls, there were no differences in rates of first shock success for induced or spontaneous arrhythmias or rate of inappropriate shocks.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Sternotomy before or after S-ICD does not confer additional risk relative to a historical control group without sternotomy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.123.011867","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T09:00:15Z","timestamp":1690189215000},"page":"468-474","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of Median Sternotomy on Safety and Efficacy of the Subcutaneous Implantable Cardioverter Defibrillator"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-6968","authenticated-orcid":true,"given":"Alan","family":"Sugrue","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rand","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2372-1586","authenticated-orcid":true,"given":"Marvin","family":"Lu","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal K.","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4913-4053","authenticated-orcid":true,"given":"Laith","family":"Alkukhun","sequence":"additional","affiliation":[{"name":"Knight Cardiovascular Institute, Oregon Health and Science University, Portland (L.A., B.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Adewumi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Cardiac Electrophysiology Section, University of Colorado Anschutz Medical Campus, Aurora (J.A., W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Schaller","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7962-9423","authenticated-orcid":true,"given":"Francis E.","family":"Marchlinski","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"D\u2019Souza","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4078-9064","authenticated-orcid":true,"given":"Babak","family":"Nazer","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.)."},{"name":"Knight Cardiovascular Institute, Oregon Health and Science University, Portland (L.A., B.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8514-1165","authenticated-orcid":true,"given":"Wendy","family":"Tzou","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Cardiac Electrophysiology Section, University of Colorado Anschutz Medical Campus, Aurora (J.A., W.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0679-860X","authenticated-orcid":true,"given":"Faisal M.","family":"Merchant","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA (R.I., M.L., N.K.B., F.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9276-4857","authenticated-orcid":true,"given":"David S.","family":"Frankel","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.S., R.D.S., F.E.M., B.D., B.N., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.10.036"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909545"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003042"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.02.047"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2016.10.016"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14615"},{"key":"e_1_3_3_8_2","first-page":"143S","article-title":"Subcutaneous ICD (S-ICD) shock due to mechanical interaction with sternotomy wires.","volume":"10","author":"Mark G","year":"2013","unstructured":"Mark, G, Skaf, J. 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