Thoracoscopic implantation of the implantable cardioverter defibrillator

The implantable cardioverter defibrillator (ICD) has become accepted treatment for the management of certain malignant ventricular arrhythmias. Implantation of the ICD usually requires an anterolateral thoracotomy through which the patch electrodes and sensing electrodes are placed, in either an intra- or an extrapericardial position, although subcostal and subxiphoid approaches are also used. This communication describes how a video-linked thoracoscopic system can be employed to implant an ICD.