Cardiologists at the Sandra Atlas Bass Heart Hospital (SABHH) at North Shore University Hospital are the first in the United States to implant a novel defibrillator outside the heart and veins to treat patients with dangerously fast heart rhythms, a condition that can lead to sudden cardiac arrest.
Developed by Medtronic, the Aurora Extravascular Implantable Cardioverter-Defibrillator (EV-ICD) system was approved by the U.S. Food and Drug Administration for commercial use on October 23, 2023. The new implantable defibrillator allows cardiologists to place the lead, or wire, under the breastbone, outside of the heart and veins. It delivers lifesaving defibrillation and paces dangerously rapid heartbeats in one system.
The minimally invasive procedure, which took about 45 minutes, was performed by Laurence Epstein, MD, system director of electrophysiology at Northwell Health on October 30, 2023.
“The first-of-its-kind Medtronic implantable defibrillator provides innovative technology that offers several benefits over traditional ICDs,” said Dr. Epstein. “With the new device, the lead can be tunneled under the sternum, outside the heart, reducing the risks of long-term complications, such as blood infections. Also, since the lead is closer to the heart, it is more energy efficient with a smaller device and longer battery life.”
Jeffrey Juettner, a 61-year-old Riverhead resident, was the first patient in the country to receive the new Medtronic implantable defibrillator. Mr. Juettner, a longtime carpenter, had been working through shortness of breath. His symptoms worsened, and on the morning of October 29, he went to the emergency department at Peconic Bay Medical Center (PBMC), part of Northwell. He was diagnosed with severe heart failure, and after consultation with cardiologists at PBMC hospital, he was transferred to the SABHH at NSUH for advanced heart failure therapy. Given his young age and risk of future infection, Dr. Epstein determined Mr. Juettner would be a good candidate for the new heart device.
“I know my heart is not in good shape,” said Mr. Juettner. “Dr. Epstein explained the procedure to me, but before that I had no idea I would be the first person to receive the new defibrillator. Dr. Epstein was great – he took away any anxiety I had about the surgery; things went well and the next morning I was doing laps around the hospital hallways. I’ll be going back to work soon.”
“Northwell Health is at the forefront of the latest care of cardiovascular patients,” said Dr. Epstein. “By offering patients the most advanced implantable defibrillator, we are truly leading the region and nation in electrophysiology and cardiac care.”
Dr. Epstein said achievements in the cardiac field at the health system are always due to the collective talents of an expert clinical team. “Our dedicated team of physicians, advanced care practitioners and technicians work seamlessly to allow us to push cutting-edge innovations and to be involved in research trials,” Dr. Epstein said, adding, “At Northwell, we have a large diverse patient population, which is important to ensure that clinical studies are representative of the patients who will use a medical product.”
The Medtronic EV-ICD system was evaluated in a worldwide pivotal study, involving 356 patients at 46 hospitals in Europe, North America, the Middle East, Asia, Australia and New Zealand. The Sandra Atlas Bass Heart Hospital at NSUH participated in the trial. In the study, the EV-ICD System achieved a defibrillation success rate of 98.7 percent and met its safety endpoints of freedom from major system and/or procedural complications at six months after implant. Results were published in The New England Journal of Medicine.1
1 Friedman P, Murgatroyd F, Boersma LVA, et al. Efficacy and Safety of an Extravascular Implantable Cardioverter-Defibrillator. N Engl J Med 2022; 387:1292-1302.
For more information about cardiology care at Northwell Health, call 833-902-2994; patient navigators are available to help with details.
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