UPMC Physicians Implant Western Pennsylvania’s First Under-Skin Defibrillator

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UPMC electrophysiologists are the first in the region to implant a totally subcutaneous defibrillator to treat life-threatening arrhythmia. The wireless device detects an irregular heartbeat and shocks the patient’s heart into a normal rhythm. The surgery was performed at UPMC Presbyterian in late January on a 59-year-old man from Worthington, Pa.

The minimally invasive procedure involved placing the subcutaneous implantable cardiac defibrillator (S-ICD) beneath the skin and outside the ribcage. The S-ICD uses electrodes placed under the skin to analyze and regulate the heart rhythm with a shock, similar to the paddles used during an emergency treatment.

The patient, who is now recovering at home, had a conventional implantable cardiac defibrillator (ICD) since he suffered an arrhythmia in 2011. An infection in his blood stream required the removal of the ICD. Usually, a replacement device would not be implanted for several weeks to allow for clearing of the infection from the blood stream. The S-ICD was implanted a few days after the old one was removed.

“With the S-ICD, the patient has a lower risk of infection and other complications because the heart is not physically connected to the device,” said Samir Saba, M.D., lead surgeon for the procedure and director of Cardiac Electrophysiology at the UPMC Heart and Vascular Institute. “This minimally invasive approach is especially beneficial if a patient requires removal of the device later in life.”

The S-ICD was approved by the FDA in 2012 and has been used in patients with congestive heart failure, cardiomyopathies and life-threatening arrhythmias.