The first procedure for the implantation of an extravascular defibrillator capable of preventing the risk of infection and occlusion of vessels was performed at the Manzoni hospital in Lecco.
A major technological step forward as the new Aurora EV-ICD device, developed by Medtronic, prevents sudden cardiac death, which is the leading cause of death for people under 60, responsible for 50% of deaths attributable to cardiovascular disease. In fact, 92% of patients affected by cardiac arrest die within a few minutes if they are not saved by a defibrillator. Cardiac death affects individuals of all ages, but is particularly relevant, as a cause of death, for adults between 30 and 40 years old (source: American Heart Association. CPR Facts & Stats. Accessed November 2019). Survival is approximately 8% without defibrillation. Every year in Europe, approximately 400 thousand cardiac arrests are recorded, 60 thousand in Italy alone.
The surgery was performed by Dr. Antonio Pani, head of the Simple Structure of Electrophysiology and by doctors Francesco Panzeri, Fabrizio Sansone and Dr. Andrea Farina, head of Cardiology in Lecco.
The innovative device is implanted with a minimally invasive approach and the positioning of the lead completely outside the heart and veins is designed to avoid long-term complications such as infections and vessel occlusion.
“Our ASST is among the six social and healthcare companies in the Lombardy Region that use such an innovative device, a real lifesaver in patients at risk of cardiac arrest – explains Marco Trivelli, General Director of the ASST of Lecco -. My heartfelt thanks to Andrea Farina, Antonio Pani and their collaborators who chose to adopt this device for our patients”.
“This type of implantable defibrillator maintains the advantages of the subcutaneous ones – adds Andrea Farina, director of Cardiology at the Manzoni hospital -, that is, the absence of components inside the vessels and the heart and therefore the risk of complications related to fractures of the catheters or infections of the device, but also of the transvenous ones, that is, the possibility of interrupting arrhythmias without causing discomfort to the patient through stimulation, in addition to the reduced size and longer battery life (more than 10 years); the ideal candidate for this procedure is therefore a patient at increased risk of complications on the catheter and infections, such as a young patient or with comorbidities, and who needs not only defibrillation but also anti-tachycardic stimulation, such as one with ischemic heart disease. Our first patient has all these characteristics being young and having had, in addition to a major heart attack, a stroke and a brain infection. The procedure was effective, without complications, and the patient was discharged home on the second post-operative day.”
“This type of procedure represents a notable step forward, especially in young patients at risk of infection who need devices capable of preventing sudden death – comments Antonio Pani, head of the Simple Electrophysiology Structure of the Manzoni hospital -. The in situ presence of cardiac surgery and vascular surgery has made it possible in recent years to refine increasingly complex electrophysiology procedures shared in our Heart Team, allowing us to offer a complete and innovative treatment path. Technological innovations such as adequately structured telemonitoring and telemedicine – concludes Pani – allow a bridge to be maintained between the hospital and the territory after discharge; specifically, our patient constantly transmits data from home which confirms the parameters of adequate functioning of the device and allows the correct continuation of treatment”.
