Post by Joshua Verbakel

Today marks an important milestone at Isala: we have restarted our extravascular ICD (EV-ICD) program. Years ago, Isala was among the pioneers in this field. After a pause, we are now back with a next-generation device and refined implantation techniques. Today, our first two patients were successfully treated with the EV-ICD as part of routine specialised care. Both patients went home safely the same day, reported almost no pain, and all device parameters were excellent. The EV-ICD is a new type of implantable defibrillator in which the shock lead is placed under the sternum. It builds on about a decade of development and clinical research and provides life-saving therapy for dangerous heart rhythms. It is particularly valuable for younger patients, patients at high risk of device-related infections, and those with specific anatomical challenges for the transvenous route. For carefully selected patients with malignant ventricular arrhythmias, the EV-ICD offers clear advantages: - No intravascular lead → fewer lead-related complications - Antitachycardia pacing (ATP) → fewer painful shocks - Longer battery life (device-dependent) - Meaningful improvements in long-term quality of life The procedures were performed by implanting cardiologists Joshua Verbakel and Ahmet Adiyaman together with cardiothoracic surgeon thanasie Markou and thoracic anaesthesiologist Chris kwik, supported by our fantastic cath lab and ICD team: Karlijn Aarnink, Jeffrey van Zanten, Han K., Linda van Oosten and Theo de Marie. This restart has only been possible thanks to close collaboration with our partners at Medtronic – Remy Verhoef (Sales Representative Cardiac Rhythm Management, Netherlands), Edwin Plasman (Senior Technical Consultant CRHF), Guido Overhof ( Senior Sales Manager Cardiac Rhythm Management, Netherlands) and Ivo Pans (Regional Director CRM Nordic & Benelux; Head of Benelux Legal & Compliance) – and the continuous support from our hospital leadership: cath lab manager Saskia Ogink, division manager Hans Lotgerink, and portfolio holder Heart Centre and Executive Board member Ina Kuper. Proud of this team effort – and, above all, of what this means for our patients. #EVICD #Cardiology #Innovation #Isala #Teamwork #Medtronic