Patient characteristics and in‐hospital complications of subcutaneous implantable cardioverter‐defibrillator for Brugada syndrome in Japan

Abstract

BackgroundClinical features and complications of subcutaneous implantable cardioverter‐defibrillator (S‐ICD) implantation for Brugada syndrome have not been well studied.MethodsWe used the Japanese Diagnosis Procedure Combination database to retrospectively investigate patients who had undergone ICD implantation between April 2016 and March 2017. We compared the characteristics and in‐hospital complications of patients with Brugada syndrome implanted with S‐ICD or transvenous (TV)‐ICD.ResultsWe extracted 3090 patients who received ICD implantation. Among them, we identified 278 Brugada patients. The mean age was 43 ± 14.4 years and 262 (94%) were male. Of these 278 patients, 136 (49%) received S‐ICD and 142 (51%) received TV‐ICD. TV‐ICD recipients had a history of atrial fibrillation more frequently compared with S‐ICD recipients. The median (interquartile range) of length of hospital stay was not significantly different between patients with S‐ICD and TV‐ICD (13 days [10‐20.5] vs 12 days [10‐18], respectively). The prevalence of in‐hospital complications after ICD implantation was similar between the two groups. There were no patients with cardiac tamponade, hemothorax, pneumothorax, cardiovascular event, stroke, and death following the procedure during hospitalization in either group.ConclusionsShort‐term safety of S‐ICD implantation may be identical to that of TV‐ICD. Large prospective studies are warranted to compare the effects and long‐term safety of S‐ICD compared with TV‐ICD.

Subcutaneous implantable cardioverter defibrillator: Can it overtake its transvenous counterpart

“…There was no difference between length of hospital stay. In the S‐ICD group the only in hospital complication was heart failure 1.5%, and in the TV‐ICD group 1.4% required lead removal, 0.7% needed a blood transfusion, and 2.1% developed heart failure 33 . There remains a concern regarding shock efficacy to convert tachyarrhythmias and IAS due to the dynamic nature of the ECG patterns seen in BrS such as polymorphic VT and low amplitude wave VF.…”