J Arrhythm. 2026 Jun 11;42(3):e70391. doi: 10.1002/joa3.70391. eCollection 2026 Jun.
ABSTRACT
Subcutaneous-to-extravascular implantable cardioverter-defibrillator exchange can create a practical challenge: the existing subcutaneous generator pocket lies posteriorly, whereas the new extravascular generator site is planned more anteriorly. In this case, fluoroscopic planning showed adjacent generator sites, allowing a single intervening pocket incision. Bidirectional dissection enabled subcutaneous generator removal and extravascular pocket creation, while separate deep-layer closure avoided a large continuous pocket and preserved standard extravascular generator positioning.
PMID:42292976 | PMC:PMC13254538 | DOI:10.1002/joa3.70391
