Long-Term Clinical Outcomes of Subcutaneous Versus Transvenous Implantable Defibrillator Therapy

Brouwer, Tom F.; Yılmaz, Dilek; Lindeboom, Robert; Buiten, Maurits S.; Nordkamp, Louise R.A. Olde; Schalij, Martin J.; Wilde, Arthur A.M.; Erven, Lieselot van; Knops, Reinoud E.

doi:10.1016/j.jacc.2016.08.044

Cited by 153 publications

(168 citation statements)

References 26 publications

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“…The rate of lead complications is lower in subcutaneous ICDs, but non-lead-related complication are more common. Infections, erosions, defibrillation failure and inappropriate shocks have been reported to occur more frequently in subcutaneous ICDs [76]. A recent metanalysis confirmed these data [77], with the exception of inappropriate shocks due to T wave oversensing which were observed more frequently in patients with a subcutaneous ICD as compared to transvenous ICDs [77].…”

Section: The Future Of Electrical Therapies In Laminopathiesmentioning

confidence: 89%

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Cardiolaminopathies from bench to bedside: challenges in clinical decision-making with focus on arrhythmia-related outcomes

Boriani

Biagini

Ziacchi

et al. 2018

Nucleus

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Lamin A/C gene mutations can be associated with cardiac diseases, usually referred to as ‘cardiolaminopathies’ characterized by arrhythmic disorders and/or left ventricular or biventricular dysfunction up to an overt picture of heart failure. The phenotypic cardiac manifestations of laminopathies are frequently mixed in complex clinical patterns and specifically may include bradyarrhythmias (sinus node disease or atrioventricular blocks), atrial arrhythmias (atrial fibrillation, atrial flutter, atrial standstill), ventricular tachyarrhythmias and heart failure of variable degrees of severity. Family history, physical examination, laboratory findings (specifically serum creatine phosphokinase values) and ECG findings are often important ‘red flags’ in diagnosing a ‘cardiolaminopathy’. Sudden arrhythmic death, thromboembolic events or stroke and severe heart failure requiring heart transplantation are the most dramatic complications of the evolution of cardiolaminopathies and appropriate risk stratification is clinically needed combined with clinical follow-up. Treatment with cardiac electrical implantable devices is indicated in case of bradyarrhythmias (implant of a device with pacemaker functions), risk of life-threatening ventricular tachyarrhythmias (implant of an ICD) or in case of heart failure with wide QRS interval (implant of a device for cardiac resynchronization). New technologies introduced in the last 5 years can help physicians to reduce device-related complications, thanks to the extension of device longevity and availability of leadless pacemakers or defibrillators, to be implanted in appropriately selected patients. An improved knowledge of the complex pathophysiological pathways involved in cardiolaminopathies and in the determinants of their progression to more severe forms will help to improve clinical management and to better target pharmacological and non-pharmacological treatments.

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Section: The Future Of Electrical Therapies In Laminopathiesmentioning

confidence: 89%

“…Data show that there are no differences in overall complications between subcutaneous and transvenous ICD but the complications of subcutaneous ICDs can be resolved easier [76]. The rate of lead complications is lower in subcutaneous ICDs, but non-lead-related complication are more common.…”

Section: The Future Of Electrical Therapies In Laminopathiesmentioning

confidence: 99%

Cardiolaminopathies from bench to bedside: challenges in clinical decision-making with focus on arrhythmia-related outcomes

Boriani

Biagini

Ziacchi

et al. 2018

Nucleus

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“…77 The authors' analysis demonstrated that the S-ICD system was more likely to deliver inappropriate therapy due to t-wave oversensing while the transvenous systems were more likely to deliver inappropriate therapy due to SVTs. S-ICD patients had more non-lead related complications which included pocket erosion, defibrillation testing failure and device failure (9.9 % versus.…”

Section: Implantable Cardioverter-defibrillator Device Selectionmentioning

confidence: 99%

ICD Therapy for Primary Prevention in Hypertrophic Cardiomyopathy

Trivedi

Knight

2016

Arrhythmia &Amp; Electrophysiology Review

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HCM is a heterogeneous disease that is classically transmitted in an autosomal dominant fashion. HCM often arises from mutations in genes responsible for the formation of cardiac sarcomeres.Sarcomeric mutations, initially discovered in the 1980s, are found in up to 70 % of patients with a family history of HCM.11 The most common mutations are in the myosin heavy chain (MYH7 gene) and myosin binding protein C (MYBPC3 gene). 12 There is marked heterogeneity in penetrance, however, and a poor understanding of how the different genotypes manifest as HCM phenotypes. Currently, there is minimal evidence to support the use of genetic testing to identify patients who are at high risk of SCD. Small studies have found that patients with a more malignant inheritance of their mutations (i.e. homozygous mutations) as well as the presence of a MYH7 gene mutation have AbstractHypertrophic cardiomyopathy (HCM) is a common and heterogeneous disorder that increases an individual's risk of sudden cardiac death (SCD). This review article discusses the relevant factors that are involved in the challenge of preventing SCD in patients with HCM.The epidemiology of SCD in patients is reviewed as well as the structural and genetic basis behind ventricular arrhythmias in HCM. The primary prevention of SCD with implantable cardioverter-defibrillator (ICD) therapy is the cornerstone of modern treatment for individuals at high risk of SCD. The focus here is on the current and emerging predictors of SCD as well as risk stratification recommendations from both North American and European guidelines. Issues related to ICD implantation, such as programming, complications and inappropriate therapies, are discussed. The emerging role of the fully subcutaneous ICD and the data regarding its implantation are reviewed. KeywordsHypertrophic cardiomyopathy, sudden cardiac death, implantable cardioverter defibrillator, subcutaneous implantable cardioverter-defibrillator Disclosure: Dr Trivedi has no conflicts of interest to declare. Dr Knight has been a consultant to manufacturers of implantable defibrillators and participated in clinical trials sponsored

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“…Although avoiding a transvenous device is appealing, it should be noted that there may be a comparable risk of non-lead-related complications over a lifetime. 42 As such, larger studies with longer-term follow-up will be necessary to further clarify relative benefits of S-ICD therapy in this patient population. One important consideration for S-ICD use in BrS patients is the potential need to perform vector testing to evaluate the patient's suitability for implantation during drug challenge, when the type 1 ECG pattern is transient.…”

Section: Treatmentmentioning

confidence: 99%

Brugada Syndrome: Evolving Insights and Emerging Treatment Strategies

Duffett

Roberts

2017

JICRM

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ABSTRACT. Brugada syndrome (BrS) is a rare inherited arrhythmia disorder associated with sudden cardiac death secondary to malignant ventricular arrhythmias. Since its first mention approximately 25 years ago, major strides have been made towards unraveling the condition's genetic and mechanistic underpinnings. Despite considerable progress, however, gaps in the understanding of BrS continue to persist, and clinical management of affected individuals remains challenging. Identification of an underlying genetic culprit continues to be elusive in the majority of patients, while discord regarding the condition's underlying pathophysiology also persists, with strong lines of evidence present for both the ''depolarization'' and ''repolarization'' hypotheses. Exciting new therapeutic options hold significant promise, including substrate-based catheter ablation and the subcutaneous implantable cardioverter-defibrillator, although the decision of when to intervene in the cases of asymptomatic patients remains unclear. Provided that the risk of events in BrS is not truly stochastic, distinct sub-phenotypes of the condition, possessing variable levels of arrhythmic risk, may exist, and their identification may lead to the improved care of BrS patients and their families.

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Long-Term Clinical Outcomes of Subcutaneous Versus Transvenous Implantable Defibrillator Therapy

Cited by 153 publications

References 26 publications

Cardiolaminopathies from bench to bedside: challenges in clinical decision-making with focus on arrhythmia-related outcomes

Cardiolaminopathies from bench to bedside: challenges in clinical decision-making with focus on arrhythmia-related outcomes

ICD Therapy for Primary Prevention in Hypertrophic Cardiomyopathy

Brugada Syndrome: Evolving Insights and Emerging Treatment Strategies

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