Saturday, 20 April 2013
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Dear Folks I am planning to insert a Tunneled (right)IJV catheterfor one of my patients with implantable cardioverter-defibrillator ( left-sided ICD). Cardiologists are insisting that ICD should not be inactivted during insertion but I am concerned regarding the risk of inappropriate ICD during procedure, specifically while passing the guidwire.I would appreciate any advice or sharing any experience re these questions: 1. Should ICD be inactivated during procedure? 2. Should I avoid using Metal guidewire? Thanks Soroush
Hi Soroush,

It's an interesting question. I presume there is a lead in both the right atrium and ventricle?

8 years ago
Hi Jordan

Thanks, yes Indeed there are two leads(shock electrodes) in-situ , one in SVC/RA and one in RV.

Hi there,

This from one of our electrophysiology cardiologists:
Generally speaking we try to avoid inserting dialysis catheters via the same access point but outside of that there usually should not be much in the way of issues. We generally do not deactivate the ICD but this may be a reasonable suggestion although the probability of creating inappropriately detected ventricle tachycardia is probably low. The best thing to do in this situation would be to place a magnet over the defibrillator during the time of catheter insertion. This will prevent the device from detecting any arrhythmias including Real ones. This would mean that it is probably a good idea to monitor the patient while a magnet is on the defibrillator. The risk of entrapping or dislodging the existing leads is likely low. Hope that helps,

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