An anomalous case of S-ICD malfunctioning: A big trouble or a soap bubble?

Crea, Pasquale; Nicotera, Angela; Crea, Bruna; Taormina, Antonio; Picciolo, Giuseppe

doi:10.1016/j.crvasa.2017.05.016

Cited by 3 publications

(3 citation statements)

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“…implanting a replacement device in a subcutaneous pocket that previously housed a larger device may result in pocket air entrapment. Several authors 11,12,18,20–23 . following the instructions of the S‐ICD manufacturer 19 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter‐defibrillator: A meta‐summary of case reports

Iavarone

Rago

Nigro

et al. 2022

Pacing Clinical Electrophis

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Background: Air entrapment has been recently described as a cause of inappropriate shock (IAS) among patients who underwent subcutaneous implantable cardioverterdefibrillator (S-ICD) implantation. Data about this complication are lacking in the literature. Methods:In this meta-summary 14 case reports describing IAS due to air entrapment were included. Patients' characteristics, S-ICD implant technique and air entrapment properties were collected.Results: All patients experienced IAS within 4 days following S-ICD implant. The subcutaneous air was demonstrated by chest x-ray in 11 cases (73.3%). The sensing vector was reprogrammed in 11 cases (73.3%), and ICD was switched off in 2 cases (1.3%).Conclusions: IAS due to air entrapment is an early complication of S-ICD implant. No association was observed between the implant technique and air retention. Diagnosis is confirmed by chest x-ray and device interrogation. Management includes switching off the device or, preferably, changing the sensing vector.

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Section: Discussionmentioning

confidence: 99%

“…Several authors. 11 , 12 , 18 , 20 , 21 , 22 , 23 following the instructions of the S‐ICD manufacturer. 19 suggest the subcutaneous injection of normal saline solution and the massage of skin to expel air from the subcutaneous space to prevent aerial entrapment during S‐ICD implantation.…”

Section: Discussionmentioning

confidence: 99%

Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter‐defibrillator: A meta‐summary of case reports

Iavarone

Rago

Nigro

et al. 2022

Pacing Clinical Electrophis

View full text Add to dashboard Cite

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“…These caused by the insulation of the sensing contact ring by the accumulation of air in the pocket. Recovery of sensing vector is expected in few days with the disappearance of the subcutaneous air [ 58 , 59 ].…”

Section: The S-icd Safetymentioning

confidence: 99%

Subcutaneous Implantable Cardioverter Defibrillators: An Overview of Implantation Techniques and Clinical Outcomes

Al‐Ghamdi

2018

CCR

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Sudden cardiac death (SCD) is a significant health problem worldwide. Multiple randomized controlled trials have shown that implantable cardioverter defibrillators (ICDs) are effective life-saving management option for individuals at risk of SCD in both primary and secondary prevention. Although the conventional transvenous ICDs (TV-ICDs) are safe and effective, there are potential complications associated with its use, including localized pocket or wound infection or systematic infection, a vascular access related complication such as pneumothorax, and venous thrombosis, and lead related complications such as dislodgement, malfunction, and perforation. Furthermore, transvenous leads placement may not be feasible in certain patients like those with venous anomaly or occlusion, or with the presence of intracardiac shunts. Transvenous leads extraction, when needed, is associated with considerable morbidity & mortality and requires significant skills and costs. Totally subcutaneous ICD (S-ICD) is designed to afford the same life-saving benefit of the conventional TV-ICDs while avoiding the shortcomings of the TV-leads and to simplify the implant techniques and hence expand the use of ICDs in clinical practice. It becomes commercially available after receiving CE mark in 2009, and it is use increased significantly after its FDA approval in 2012. This review aims to give an overview of the S-ICD system components, implantation procedure, clinical indications, safety, efficacy, and future directions.

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Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: a systematic review of the literature

et al. 2022

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Aims Air entrapment (AE) has been reported as a potential cause of early inappropriate shocks (ISs) following subcutaneous implantable cardioverter defibrillator (S-ICD) implantation, but a cause–effect relationship is not always evident. This systematic review aims to analyse this phenomenon concerning implantation techniques, electrogram (EGM) features, radiologic findings, and patient management. Methods and results A systematic search was conducted using PubMed, Embase, and Google Scholar databases following the PRISMA guidelines to obtain all available literature data since 2010 on S-ICD malfunctions possibly due to AE. The final analysis included 54 patients with AE as a potential cause of S-ICD malfunction. Overall, the aggregate incidence of this condition was 1.2%. Of ICD malfunctions possibly due to AE, 93% were ISs, and 95% were recorded within the first week following implantation. Radiologic diagnosis of AE was confirmed in 28% of the entire study cohort and in 68% of patients in whom this diagnostic examination was reported. At the time of device malfunction, EGMs showed artefacts, baseline drift, and QRS voltage reduction in 95, 76, and 67% of episodes, respectively. Management included ICD reprogramming or testing, no action (observation), and invasive implant revision in 57, 33, and 10% of patients, respectively. No recurrences occurred during follow-up, irrespective of management performed. Conclusions Device malfunction possibly due to AE may occur in ∼1% of S-ICD recipients. Diagnosis is strongly suggested by early occurrence, characteristic EGM features, and radiologic findings. Non-invasive management, principally device reprogramming, appears to be effective in most patients.

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An anomalous case of S-ICD malfunctioning: A big trouble or a soap bubble?

Cited by 3 publications

References 4 publications

Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter‐defibrillator: A meta‐summary of case reports

Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter‐defibrillator: A meta‐summary of case reports

Subcutaneous Implantable Cardioverter Defibrillators: An Overview of Implantation Techniques and Clinical Outcomes

Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: a systematic review of the literature

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