Lifesaver under the skin

Defibrillator with sternum electrode implanted for the first time at Göttingen University Medical Center to prevent sudden cardiac death.

At the Heart Center of the University Medical Center Göttingen (UMG), a new type of defibrillator with a sternum electrode was implanted for the first time in a patient with cardiac arrhythmia: The Aurora system is a defibrillator that lies outside the heart and prevents sudden cardiac death.

According to the German Heart Foundation, around 65,000 people die of sudden cardiac death in Germany every year. This corresponds to 20 percent of all deaths caused by cardiovascular diseases. Sudden cardiac death is caused by rapid cardiac arrhythmia in the main ventricles, known as ventricular fibrillation. Without treatment, this leads to circulatory arrest within a few minutes and is often fatal. It is therefore important to treat people who have an increased risk of sudden cardiac death at an early stage, for example due to severe heart failure.

Dr. Leonard Bergau, Deputy Head of the Clinical Electrophysiology Unit and Senior Physician at the UMG’s Department of Cardiology and Pneumology, shows the new defibrillator. (c) umg/samer al mhethawi

For these patients, it can be helpful to use an implantable cardioverter defibrillator (ICD), commonly known as a defibrillator. The ICD system usually consists of a defibrillator and one or more cable-shaped electrodes. The defibrillator monitors the heart and automatically provides the right therapy to correct dangerous palpitations at their onset. Electrodes transmit the electrical impulses from the defibrillator to the heart and, conversely, provide information about the heart’s natural activity back to the ICD. After implantation, the ICD system can be controlled and programmed via an external computer in the treating clinic or practice. With conventional defibrillators, the electrode is placed below the collarbone, guided into the heart via a large vein and anchored there. If a dangerous cardiac arrhythmia occurs, the defibrillator emits either weak impulses or an electric shock to stabilize the heart rhythm again and thus prevent sudden cardiac death.

The Aurora system is a new type of ICD that has been approved for therapy in Europe since this year and was implanted for the first time at the Heart Center of the University Medical Center Göttingen (UMG). The special feature of this system is that there is no direct connection to the heart. “The Aurora system is a so-called extravascular system. The electrode, which is normally anchored in the heart, is guided below the sternum and lies on the heart. The defibrillator itself is inserted under the left armpit. In the rare event of an infection, this cannot enter the bloodstream directly, as the Aurora system is not placed in the heart. This is a great advantage for patients,” explains Dr. Leonard Bergau, Deputy Head of the Clinical Electrophysiology Unit and Senior Physician at the UMG’s Department of Cardiology and Pneumology. This system is particularly important for dialysis patients, as the vascular access to the heart does not have to be relocated.

According to Dr. Bergau, conventional defibrillators have proven their worth and the technology is well advanced. Nevertheless, there are weaknesses. “In addition to possible infections that they can trigger, the electrode can break over time or injure the lungs during implantation. The Aurora system offers the advantage that the electrode can be replaced more easily without having to remove the probe directly from the heart. The procedure or replacement of the electrode is therefore less dangerous for patients,” says Dr. Bergau.

“I am delighted that we have been able to significantly expand the range of services at the Heart Center with the Aurora system,” says Prof. Dr. Karl Toischer, Head (acting) of the Clinic for Cardiology and Pneumology at the UMG. “Of course, we decide which system is most suitable on an individual basis and depending on the clinical picture together with the patient.”

Heart Center of the University Medical Center Göttingen

In the Heart Center of the University Medical Center Göttingen, 14 clinics and institutes as well as the nursing and nursing function service of the University Medical Center Göttingen work together in the areas of heart, blood vessels, lungs and kidneys. These organs are particularly closely linked in their function. The clinics and institutes have been brought together to form an interdisciplinary center. This ensures optimal and efficient patient care, research and teaching. The aim of the UMG Heart Center is to practice high-quality medicine in a patient-oriented, open-minded and transparent manner.

Wissenschaftliche Ansprechpartner:

University Medical Center Göttingen, University of Göttingen
Clinic for Cardiology and Pneumology
Dr. Leonard Bergau
Robert-Koch-Str. 40, 37075 Göttingen
Phone +49 551 / 39-62983
herzzentrum@med.uni-goettingen.de
herzzentrum.umg.eu

https://www.umg.eu/en/news-detail/news-detail/detail/news/lifesaver-under-the-skin-defibrillator-with-sternum-electrode-implanted-for-the-first-time-at-goetti/