Entirely subcutaneous defibrillator and complex congenital heart disease: Data on long-term clinical follow-up

Ferrero, Paolo; Ali, Hussam; Barman, Palash; Foresti, Sara; Lupo, Pierpaolo; D’Elia, Emilia; Cappato, Riccardo; Stuart, Graham

doi:10.4330/wjc.v9.i6.547

Cited by 16 publications

(7 citation statements)

References 20 publications

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“…Ferro et al. showed similar outcomes in eight patients with S‐ICD and ACHD in the secondary prevention setting . The main reason for this approach was the inability to implant a standard ICD percutaneously.…”

Section: Discussionmentioning

confidence: 96%

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Eligibility for subcutaneous implantable cardioverter defibrillators in the adult congenital heart disease population

Garside

Leyva

Hudsmith

et al. 2018

Pacing Clinical Electrophis

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Background Patients with adult congenital heart disease (ACHD) have an increased risk of arrhythmic and sudden cardiac death. The subcutaneous implantable cardioverter defibrillator (S‐ICD) provides a potentially safer alternative to transvenous ICDs in ACHD. Suitability for S‐ICD depends on the surface electrocardiogram (ECG), which is often abnormal in ACHD patients. This study investigates the proportion of ACHD patients who meet the screening criteria for S‐ICD implantation. Methods A standard screening ECG was performed in 102 patients with complex ACHD (Tetralogy of Fallot, Fontan circulation, and transposition of the great arteries). This process was repeated postexercise for patients who also had an exercise test. Results Three quarters (75.4%) of ACHD patients meet screening criteria for an S‐ICD with at least one suitable vector. The most common number of acceptable vectors in the eligible group was two (35% of total population). In only 12% of total population, all three vectors were suitable while only one vector was suitable in 28% of total population. The primary vector (equivalent of ECG lead III) was the most common suitable vector, found in 62% of participants who had appropriate sensing vectors. Twenty‐five (24.5%) patients failed to meet the S‐ICD screening criteria. Of these, 14 had repaired tetralogy of Fallot. A total of 92% of patients with a Fontan circulation met ECG screening criteria. Of those who had the protocol repeated following their cardiopulmonary exercise test (n = 14), only one additional patient failed to meet the eligibility criteria. Conclusions A quarter of ACHD patients do not meet the eligibility criteria for the S‐ICD. However, more than 90% of patients with a Fontan circulation are suitable for an S‐ICD.

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Section: Discussionmentioning

confidence: 96%

“…15 Ferro et al showed similar outcomes in eight patients with S-ICD and ACHD in the secondary prevention setting. 16 The main percutaneously. This group showed a similar inappropriate shock rate (12.5%).…”

Section: Discussionmentioning

confidence: 99%

Eligibility for subcutaneous implantable cardioverter defibrillators in the adult congenital heart disease population

Garside

Leyva

Hudsmith

et al. 2018

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…No patient had IAS due to over sensing. One patient had an appropriate shock during follow up, and several episodes of self‐terminating VT were noted 34 …”

Section: Discussionmentioning

confidence: 99%

Subcutaneous implantable cardioverter defibrillator: Can it overtake its transvenous counterpart

Savarimuthu

Roy

Obeidat

et al. 2021

Pacing Clinical Electrophis

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Over the past decade, the emergence of the subcutaneous implantable cardioverter defibrillator (S‐ICD) has provided cardiologists with an option to provide both primary or secondary prevention treatment of sudden cardiac death (SCD) without the associated risks that come with the use of intracardiac leads. S‐ICD may prove to be a useful option in those who are young, have thromboembolic risk, immunodeficiency states, unfavorable anatomy due to adult congenital heart disease (ACHD). This article reviews the existing literature to determine whether S‐ICD can prove to be a safe alternative in comparison to Transvenous implantable cardioverter defibrillator (TV‐ICD) and in which patient population should S‐ICD be considered over TV‐ICD.

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“…54 In another study of eight patients with CHD (seven adults and one child) followed for a median of 2.3 years, there were no inappropriate therapies administered during the entirety of follow-up. 55 Anecdotally, other challenges to S-ICD implantation include patients with dextrocardia, for whom the implantation technique must be mirror-imaged. In addition, patients who have undergone one or more sternotomies may have significant chest wall deformities that make tunneling the lead along the sternum a more challenging task.…”

Section: Subcutaneous Devicesmentioning

confidence: 99%

Implantable Cardioverter-defibrillators in Adult Congenital Heart Disease

Stewart

Macicek

Morin

2018

J Innov Cardiac Rhythm Manage.

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With improved surgical techniques and medical therapies, many patients who are born with complex congenital heart defects are now living well into adulthood. As these patients age, an increasingly common cause of mortality is sudden cardiac death (SCD) from ventricular tachyarrhythmias. The implantable cardioverter-defibrillator (ICD) is a therapy with the ability to prevent some of these deaths; however, there are many diagnostic and technical challenges that remain in the congenital heart disease (CHD) population. We performed a literature review, searching PubMed for articles that examined the role of ICDs in CHD. We herein present the evidence for when to place an ICD in CHD patients, stratified by subtype as relevant. Then, we discuss the technical challenges and complications that are unique to this patient population. We conclude that, despite active work in the area, more research is needed given the small event rates and clinical variability within CHD populations.

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Entirely subcutaneous defibrillator and complex congenital heart disease: Data on long-term clinical follow-up

Cited by 16 publications

References 20 publications

Eligibility for subcutaneous implantable cardioverter defibrillators in the adult congenital heart disease population

Eligibility for subcutaneous implantable cardioverter defibrillators in the adult congenital heart disease population

Subcutaneous implantable cardioverter defibrillator: Can it overtake its transvenous counterpart

Implantable Cardioverter-defibrillators in Adult Congenital Heart Disease

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