Feasibility of Defibrillation and Automatic Arrhythmia Detection Using an Exclusively Subcutaneous Defibrillator System in Canines

Cappato, Riccardo; Castelvecchio, Serenella; Erlinger, Paul; Sanghera, Rick; Scheck, Donald; Ostroff, Alan; Rissmann, William; Gropper, Charles; Bardy, Gust H.

doi:10.1111/j.1540-8167.2012.02432.x

Cited by 12 publications

(14 citation statements)

References 22 publications

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“…Using canine subjects, Cappato et al tested 11 different dual electrode configurations for their ability to terminate induced VF. 20 All configurations demonstrated a 100% termination rate for induced VF but required up to 80 J to do so, higher than the shock energy requirement for TV-ICDs to effectively terminate arrhythmias. Building on these results, Bardy …”

Section: Development Of the S-icd Systemmentioning

confidence: 99%

The Subcutaneous Implantable Cardioverter Defibrillator

Mangels

Frishman

2016

Cardiology in Review

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The subcutaneous implantable cardioverter defibrillator (S-ICD) is a subcutaneous alternative to conventional transvenous ICD (TV-ICD) systems, which have previously been shown to treat life-threatening ventricular tachyarrhythmias in cardiac disease patients. A review of the literature reveals that S-ICDs have similar shock efficacy rates for both induced and spontaneous ventricular tachyarrhythmias when compared with TV-ICDs. Furthermore, S-ICDs seem to have a higher specificity for withholding therapy when supraventricular tachycardia is present compared with TV-ICDs. The advantages of the S-ICD system are numerous: fewer vascular complications including thrombosis and hemothorax, avoidance of fluoroscopy, and an easier means of lead replacement. These advantages make the S-ICD system most suitable for younger patients who may require replacements in later life, those with abnormal venous anatomy, and individuals prone to infection and/or central vein thrombosis. However, S-ICDs are not without their complications and are associated with a higher incidence of inappropriate shocks secondary to T wave oversensing. S-ICDs also lack antitachycardia pacing, making them a suboptimal device in patients with recurrent monomorphic ventricular tachycardia who would otherwise benefit from the antitachycardia pacing offered in TV-ICDs. Lastly, the limited number of long-term randomized, head-to-head studies involving direct comparison with TV-ICDs poses a challenge in the implementation of the S-ICD.

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Section: Development Of the S-icd Systemmentioning

confidence: 99%

The Subcutaneous Implantable Cardioverter Defibrillator

Mangels

Frishman

2016

Cardiology in Review

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“…So far, the subcutaneous ICD proved to be feasible and safe. 3,6,7 Due to the subcutaneous position of the system, the sensing of the S-ICD is different from transvenous ICDs. Comparable to transvenous ICD systems, the S-ICD continuously monitors the hearth rhythm by recording the rate of the QRS-complexes on an ICD-registered ECG.…”

Section: Introductionmentioning

confidence: 99%

Which Patients Are Not Suitable for a Subcutaneous ICD: Incidence and Predictors of Failed QRS‐T‐Wave Morphology Screening

Nordkamp

Warnaars

Kooiman

et al. 2014

Cardiovasc electrophysiol

123

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In patients without an indication for pacing, 7.4% would have been not suitable for a S-ICD according to the TMS. HCM, a heavy weight, a prolonged QRS duration and a R:T ratio <3 in the ECG lead with the largest T wave were independently associated with TMS failure. These data might alert physicians that selection of patients for a S-ICD should be considered with special caution in certain patient groups, because they may not satisfy ECG criteria for adequate sensing.

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“…Defibrillation efficacy for SQ defibrillation systems has been previously reported for both animals and humans leading to the first permanent implants of a SQ‐only system employing anterior and anterolateral electrodes . For conventional ICD systems, posteriorly tunneled SQ electrodes have in the past been used to lower defibrillation thresholds by improving the shock vector .…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Study of Shock Pathways for Subcutaneous Implantable Defibrillators

Kuschyk

Milašinović

Kühlkamp

et al. 2013

Cardiovasc electrophysiol

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Feasibility of Defibrillation and Automatic Arrhythmia Detection Using an Exclusively Subcutaneous Defibrillator System in Canines

Abstract: Subcutaneous defibrillation using different electrode combinations with shock energies less than 80 J terminated all induced VFs. An automatic SICD proved effective in detecting and activating shock delivery in all cases.

Cited by 12 publications

References 22 publications

The Subcutaneous Implantable Cardioverter Defibrillator

The Subcutaneous Implantable Cardioverter Defibrillator

Which Patients Are Not Suitable for a Subcutaneous ICD: Incidence and Predictors of Failed QRS‐T‐Wave Morphology Screening

A Multicenter Study of Shock Pathways for Subcutaneous Implantable Defibrillators

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