The implantation of a cardioverter defibrillator involves using a guide device to tunnel beneath the skin from the side of the chest below the armpit to the top of the breastbone near the collarbone. Although this is a routine procedure, these implantations can be difficult as the tunneling device needs to change direction, up to 90 degrees, in order to navigate to the necessary location. The tools currently used to perform these procedures are unable to easily pivot and change direction when working through the soft tissue, yet implantation of a subcutaneous defibrillator requires significant manipulation of a lead wire and electrode directly under the skin. As such, the implantation of a cardioverter defibrillator requires multiple incisions, adding complexity and time to the operation. In fact, the average procedure for implanting a subcutaneous defibrillator requires 3 incisions to navigate the subcutaneous space. These necessary manipulations can prove distressing to some, especially among pediatric patients. In the US, approximately 150,000 implantable cardioverter defibrillators are implanted each year. 

Cardiothoracic surgeon Dr. Randy Stevens of St. Christopher's Hospital for Children has developed a new implantation device that can overcome these challenges by pivoting during the implantation of a defibrillator. This tunneling device can be used to place leads or guide wires, and it possesses the ability to accommodate changes in direction without the need for additional incisions, reducing the time, complexity, and materials necessary to complete the procedure.