The Entirely Subcutaneous Implantable Cardioverter-Defibrillator

Abstract

This study demonstrates that the S-ICD is effective in terminating ventricular arrhythmias. There is, however, a considerable percentage of ICD related adverse events, which decreases as the therapy evolves and experience increases.

Low Prevalence of Inappropriate Shocks in Patients With Inherited Arrhythmia Syndromes With the Subcutaneous Implantable Defibrillator Single Center Experience and Long‐Term Follow‐Up

“…Our results demonstrate that the S‐ICD is safe and effective in terminating both induced and spontaneous VF and corroborate results reported by other researchers and larger groups of patients 3, 4. Our population was generally younger with a more‐preserved ejection fraction than those previously reported in prospective ICD trials, also commonly presenting with a rapid unstable VT/VF, rather than monomorphic VT. We included patients with a primary as well as secondary ICD indication.…”

“…One study has demonstrated the association between operator experience and the risk of inadequate therapy 4. Compared with our results, we can confirm that, in our cohort, the patient with inappropriate shocks was implanted at the early phase of the S‐ICD and before the introduction of algorithms for prevention of myopotential oversensing, which may also play an important role in the safety of the S‐ICD system.…”

“…First S‐ICD studies reported up to 15% yearly rates of inappropriate shocks,4 with TWOS accounting for the vast majority of cases 5. The addition of a conditional tachycardia detection zone (2 zones versus 1 zone programming) significantly decreased the rate of inappropriate shocks attributed to supraventricular rhythms and TWOS 16.…”

Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death

“…Still, the subcutaneous ICD shares many of the same hazards as transvenous ICDs, including lead dislodgement (2.5%), skin erosion (1.7%), and infection (5.9%), along with a 13% incidence of inappropriate shocks during follow-up. 40 Although subcutaneous ICDs have been shown to effectively terminate electrically induced VF, the effectiveness of the subcutaneous ICD compared with the transvenous ICD in improving survival from spontaneous VF has yet to be established. 41 External defibrillators and ICDs offer potential lifesaving therapy for malignant tachyarrhythmias.…”

The subcutaneous implantable cardioverter-defibrillator: pros and cons

“…Current evidence is based on a certain number of regulatory studies [15,22] as well as several post-marketing studies, mostly multicentric [16,19,21,[27][28][29]. Follow-up remains relatively short, the longest being the pooled analysis of the EFFORTLESS and IDE registries with a mean follow-up of less than 2 years [20].…”