Subcutaneous implantable cardioverter-defibrillator and defibrillation testing: A propensity-matched pilot study

Forleo, Giovanni B.; Gasperetti, Alessio; Berndt, Alexander; Laredo, Mikaël; Schiavone, Marco; Ziacchi, Matteo; Vogler, Julia; Ricciardi, Danilo; Palmisano, Pietro; Piro, Agostino; Compagnucci, Paolo; Waintraub, Xavier; Mitacchione, Gianfranco; Carrassa, Gianmarco; Russo, Giulia; Bonis, Silvana De; Angeletti, Andrea; Bisignani, Antonio; Picarelli, Francesco; Casella, Michela; Bressi, Edoardo; Rovaris, Giovanni; Calò, Leonardo; Santini, Luca; Pignalberi, Carlo; Lavalle, Carlo; Viecca, Maurizio; Pisanò, E; Olivotto, Iacopo; Curnis, Antonio; Russo, Antonio Dello; Tondo, Claudio; Love, Charles J.; Biase, Luigi Di; Steffel, Jan; Tilz, Roland Richard; Badenco, Nicolas; Biffi, Mauro

doi:10.1016/j.hrthm.2021.06.1201

Cited by 17 publications

(8 citation statements)

References 20 publications

(34 reference statements)

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“…For this reason, the possibility of a DFT-free implant is being considered. In a study involving 1290 patients, DFT performance was not associated with significant differences in cardiovascular mortality and ineffective shocks, suggesting that its omission may be safe [ 94 ]. The PRAETORIAN score is an algorithm developed to identify patients with high defibrillation thresholds using a routine chest radiograph and provides feedback to implanters on S-ICD positioning.…”

Section: Future Perspectivesmentioning

confidence: 99%

Subcutaneous Implantable Cardioverter Defibrillator: A Contemporary Overview

Guarracini,

Preda,

Bonvicini

et al. 2023

Life

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The difference between subcutaneous implantable cardioverter defibrillators (S-ICDs) and transvenous ICDs (TV-ICDs) concerns a whole extra thoracic implantation, including a defibrillator coil and pulse generator, without endovascular components. The improved safety profile has allowed the S-ICD to be rapidly taken up, especially among younger patients. Reports of its role in different cardiac diseases at high risk of SCD such as hypertrophic and arrhythmic cardiomyopathies, as well as channelopathies, is increasing. S-ICDs show comparable efficacy, reliability, and safety outcomes compared to TV-ICD. However, some technical issues (i.e., the inability to perform anti-bradycardia pacing) strongly limit the employment of S-ICDs. Therefore, it still remains only an alternative to the traditional ICD thus far. This review aims to provide a contemporary overview of the role of S-ICDs compared to TV-ICDs in clinical practice, including technical aspects regarding device manufacture and implantation techniques. Newer outlooks and future perspectives of S-ICDs are also brought up to date.

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Section: Future Perspectivesmentioning

confidence: 99%

Subcutaneous Implantable Cardioverter Defibrillator: A Contemporary Overview

Guarracini,

Preda,

Bonvicini

et al. 2023

Life

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“…Mutations in 13 genes have been traditionally associated with LQTS: among those, mutations in potassiumchannel genes KCNQ1 (LQT1 locus) and KCNH2 (LQT2 locus) and the sodium-channel gene SCN5A (LQT3 locus) are the most common causes of the LQTS and account for approximately 75% of cases 30 . Once diagnosis is made, risk stratification is mandatory to tailor lifestyle changes and to deliver the adequate therapy, such as implantable cardioverter defibrillator J o u r n a l P r e -p r o o f (ICD) in high-risk patients, with the modern subcutaneous ICD potentially being the most appropriate therapeutic option [31][32][33][34][35] . All LQTS patients, regardless of the SCD risk, should avoid QT-prolonging drugs, promptly correct electrolyte abnormalities (hypokalemia, hypomagnesaemia, hypocalcemia) that may occur during diarrhea, vomiting or metabolic conditions and avoid genotype-specific triggers for arrhythmias (strenuous swimming, especially in LQTS1, and exposure to loud noises in LQTS2 patients) 36 .…”

Section: Non Modifiable Risk Factorsmentioning

confidence: 99%

Arrhythmogenic Risk and Mechanisms of QT-Prolonging Drugs to Treat COVID-19

Schiavone

Gasperetti

Gherbesi

et al. 2022

Cardiac Electrophysiology Clinics

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“…DFT is still required for S-ICD systems; it is typically performed with an energy of 65J, and it may be of clinical value in selected patients [ 4 ]. Nonetheless, there are publications reporting acceptable efficacy of S-ICD systems implanted without DFT [ 5 , 6 , 7 ]. Moreover, efforts are being made to investigate the true amount of energy needed to successfully terminate ventricular fibrillation [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…The score was initially designed to objectively assess the final location of the system and to correlate it with DFT. It was then validated in available retrospective cohorts [ 14 ], and in separate cohorts [ 7 , 16 ]. Currently, the next step of research is ongoing, with the aim of skipping DFT entirely and substituting it with the score evaluation only (i.e., prospective validation of the score by randomizing to standard DFT or using only the score without conversion testing; the PRAETORIAN DFT study) [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Real-Life Inter-Rater Variability of the PRAETORIAN Score Values

Budrejko

Kempa

Krupa

et al. 2022

IJERPH

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(1) Background: The PRAETORIAN score is a tool developed for postoperative evaluation of the position of subcutaneous implantable cardioverter-defibrillator systems. The aim of our study was to evaluate the real-life inter-rater variability of the PRAETORIAN score, based on chest radiographs of S-ICD patients reviewed by independent clinical raters. (2) Methods: Postoperative chest X-rays of patients that underwent S-ICD implantation were evaluated by five clinical raters who gave values of the PRAETORIAN score. Ratings were then compared in a fully crossed manner to determine the inter-rater variability of the attributed scores. (3) Results: In total, 87 patients were included in the study. In the case of the most important final risk category of the PRAETORIAN score, the mean Light’s kappa was 0.804, the Fleiss’ kappa was 0.249, and the intraclass correlation was 0.38. The final risk category was identically determined by all five raters in 75.86% of patients, by four raters in 14.94%, and by three raters in 9.20% of patients. (4) Conclusions: The overall inter-rater variability of the PRAETORIAN score in a group of electrophysiologists experienced in S-ICD implantation, yet previously naive to the PRAETORIAN score, and self-trained in its utilization, was only modest in our study. Appropriate use of the score might require training of clinical raters.

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Subcutaneous implantable cardioverter-defibrillator and defibrillation testing: A propensity-matched pilot study

Cited by 17 publications

References 20 publications

Subcutaneous Implantable Cardioverter Defibrillator: A Contemporary Overview

Subcutaneous Implantable Cardioverter Defibrillator: A Contemporary Overview

Arrhythmogenic Risk and Mechanisms of QT-Prolonging Drugs to Treat COVID-19

Real-Life Inter-Rater Variability of the PRAETORIAN Score Values

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