Pooled Analysis of Complications with Transvenous ICD Compared to Subcutaneous ICD in Patients with Catecholaminergic Polymorphic Ventricular Arrhythmia

Eckert, Henrik; El‐Battrawy, Ibrahim; Veith, Michael; Roterberg, Gretje; Kowitz, Jacqueline; Lang, Siegfried; Zhou, Xiaobo; Akın, İbrahim; Mügge, Andreas; Aweimer, Assem

doi:10.3390/jpm12040536

Cited by 9 publications

(7 citation statements)

References 36 publications

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“…[46][47][48] Subcutaneous ICDs (S-ICD) show a certain advantage regarding lead-related complications, still documenting problems with inappropriate shocks and other ICDrelated complications. 49 Current guidelines clearly state that an ICD is recommended in CPVT patients "only after cardiac arrest, recurrent syncope or catecholamine-induced bidirectional VT despite optimal medical management and/or left cardiac sympathetic denervation", 36 and a case-by-case decision between ICD and S-ICD may be today advised. 49…”

Section: Perspectives In Therapeutic Managementmentioning

confidence: 99%

“…49 Current guidelines clearly state that an ICD is recommended in CPVT patients "only after cardiac arrest, recurrent syncope or catecholamine-induced bidirectional VT despite optimal medical management and/or left cardiac sympathetic denervation", 36 and a case-by-case decision between ICD and S-ICD may be today advised. 49…”

Section: Perspectives In Therapeutic Managementmentioning

confidence: 99%

“…However, painful shocks may also trigger further adrenergic stress as well as arrhythmias, while high rates of lead failure and failure to convert bidirectional VTs or triggering of electrical storms have been documented 46–48 . Subcutaneous ICDs (S‐ICD) show a certain advantage regarding lead‐related complications, still documenting problems with inappropriate shocks and other ICD‐related complications 49 . Current guidelines clearly state that an ICD is recommended in CPVT patients “only after cardiac arrest, recurrent syncope or catecholamine‐induced bidirectional VT despite optimal medical management and/or left cardiac sympathetic denervation”, 36 and a case‐by‐case decision between ICD and S‐ICD may be today advised 49 …”

Section: Introductionmentioning

confidence: 99%

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Athletes and suspected catecholaminergic polymorphic ventricular tachycardia: Awareness and current knowledge

Mascia,

Brugada,

Arbelo

et al. 2023

Cardiovasc electrophysiol

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IntroductionCatecholaminergic polymorphic ventricular tachycardia (CPVT) is a cardiac inherited arrhythmogenic disease potentially leading to sudden cardiac death that is determined by electrical instability exacerbated by acute adrenergic tone.Methods and ResultsDespite its life‐threatening nature, CPVT remains potentially unnoticed since diagnosis may be difficult especially in apparently healthy athletes. This review summarizes current knowledge and shortcomings of CPVT, focusing on genetics, arrhythmic mechanisms, sport preparticipation screening, and current recommendations.ConclusionsThe paper captures the importance of CPVT athletes regarding the necessity of risk stratification, as well as the importance of maintaining a healthy lifestyle.

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Section: Perspectives In Therapeutic Managementmentioning

confidence: 99%

Section: Perspectives In Therapeutic Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Athletes and suspected catecholaminergic polymorphic ventricular tachycardia: Awareness and current knowledge

Mascia,

Brugada,

Arbelo

et al. 2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…While the ICD generator can is usually positioned in left subclavicular subcutaneous or sub-pectoral positions, the sub-cutaneous ICD (S-ICD) is located along the left midaxillary line. The S-ICD is an extra-vascular "shock box" most often indicated in young adult patients with either IPAS or a form of dilative cardiomyopathy in the absence of a pacing indication for bradycardia (8,9). This type of ICD has shown reduction of long-term devicerelated complications (9)(10)(11) in different IPAS patient series.…”

Section: Early Assessment and Inhibition Of Icd Therapiesmentioning

confidence: 99%

“…The S-ICD is an extra-vascular "shock box" most often indicated in young adult patients with either IPAS or a form of dilative cardiomyopathy in the absence of a pacing indication for bradycardia (8,9). This type of ICD has shown reduction of long-term devicerelated complications (9)(10)(11) in different IPAS patient series. In pediatric patients with ICDs, the ICD generator is often located in the upper abdominal quadrants.…”

Section: Early Assessment and Inhibition Of Icd Therapiesmentioning

confidence: 99%

Management of hemodynamically stable wide QRS complex tachycardia in patients with implantable cardioverter defibrillators

Regoli

Cattaneo²,

Kola³

et al. 2023

Front. Cardiovasc. Med.

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Management of hemodynamically stable, incessant wide QRS complex tachycardia (WCT) in patients who already have an implantable cardioverter defibrillator (ICD) is challenging. First-line treatment is performed by medical staff who have no knowledge on programmed ICD therapy settings and there is always some concern for unexpected ICD shock. In these patients, a structured approach is necessary from presentation to therapy. The present review provides a systematic approach in four distinct phases to guide any physician involved in the management of these patients: PHASE I: assessment of hemodynamic status and use of the magnet to temporarily suspend ICD therapies, especially shocks; identification of possible arrhythmia triggers; risk stratification in case of electrical storm (ES). PHASE II: The preparation phase includes reversal of potential arrhythmia “triggers”, mild patient sedation, and patient monitoring for therapy delivery. Based on resource availability and competences, the most adequate therapeutic approach is chosen. This choice depends on whether a device specialist is readily available or not. In the case of ES in a “high-risk” patient an accelerated patient management protocol is advocated, which considers urgent ventricular tachycardia transcatheter ablation with or without mechanical cardiocirculatory support. PHASE III: Therapeutic phase is based on the use of intravenous anti-arrhythmic drugs mostly indicated in this clinical context are presented. Device interrogation is very important in this phase when sustained monomorphic VT diagnosis is confirmed, then ICD ATP algorithms, based on underlying VT cycle length, are proposed. In high-risk patients with intractable ES, intensive patient management considers MCS and transcatheter ablation. PHASE IV: The patient is hospitalized for further diagnostics and management aimed at preventing arrhythmia recurrences.

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Predictors of ventricular tachyarrhythmia in patients with a wearable cardioverter defibrillator: an international multicenter registry

Kreimer,

Koepsel,

Gotzmann

et al. 2024

J Interv Card Electrophysiol

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Background and aims Wearable cardioverter defibrillator (WCD) can protect patients from sudden cardiac death due to ventricular tachyarrhythmias and serve as a bridge to decision of definite defibrillator implantation. The aim of this analysis from an international, multicenter WCD registry was to identify predictors of sustained ventricular tachycardia (VT) and/or ventricular fibrillation (VF) in this population. Methods One thousand six hundred seventy-five patients with WCD were included in a multicenter registry from 9 European centers, with a median follow-up of 440 days (IQR 120–893). The primary study end point was the occurrence of sustained VT/VF. Results Sustained VT was detected by WCD in 5.4% and VF in 0.9% of all patients. Of the 30.3% of patients receiving ICD implantation during follow-up, sustained VT was recorded in 9.3% and VF in 2.6%. Non-ischemic cardiomyopathy (HR 0.5, p < 0.001), and medication with angiotensin-converting enzyme inhibitors (HR 0.7, p = 0.027) and aldosterone antagonists (HR 0.7, p = 0.005) were associated with a significantly lower risk of VT/VF. Conclusions Patients who received WCD due to a transient increased risk of sudden cardiac death have a comparatively lower risk of VT/VF in the presence of non-ischemic cardiomyopathy. Of note, optimal medical treatment for heart failure not only results in an improvement in left ventricular ejection fraction but also in a reduction in the risk for VT/VF. Graphical Abstract

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Pooled Analysis of Complications with Transvenous ICD Compared to Subcutaneous ICD in Patients with Catecholaminergic Polymorphic Ventricular Arrhythmia

Cited by 9 publications

References 36 publications

Athletes and suspected catecholaminergic polymorphic ventricular tachycardia: Awareness and current knowledge

Athletes and suspected catecholaminergic polymorphic ventricular tachycardia: Awareness and current knowledge

Management of hemodynamically stable wide QRS complex tachycardia in patients with implantable cardioverter defibrillators

Predictors of ventricular tachyarrhythmia in patients with a wearable cardioverter defibrillator: an international multicenter registry

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