Sub-generator fat as a potential risk factor for high defibrillation threshold in an extravascular implantable cardioverter-defibrillator: A case report

HeartRhythm Case Reports 2026 Open access

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Authors: Tsukasa Oshima, Kenichiro Yamagata, Katsuhito Fujiu, N Takeda
DOI: 10.1016/j.hrcr.2026.02.017
Cited by: 0
References: 8

Abstract

Implantable cardioverter-defibrillators (ICDs) effectively prevent sudden cardiac death(1). The extravascular ICD (EV-ICD) is a novel system that avoids transvenous leads by placing a single lead in the substernal space(2,3). Although defibrillation threshold (DFT) testing is typically recommended for EV-ICDs, the factors associated with high DFT remain unclear. In subcutaneous ICDs (S-ICDs), sub-coil and sub-generator fat have been reported as predictors of high DFT, likely due to attenuation of the shock vector(4).

Fields of Study & Subjects

Cardiac pacing and defibrillation studies Cardiac electrophysiology and arrhythmias Cardiac Arrest and Resuscitation

Publication details

Journal / source
HeartRhythm Case Reports
Volume
12
Issue
6
Pages
617–619
Publication date
27 February 2026
Language
EN