Use of a discrimination algorithm to reduce inappropriate shocks with a subcutaneous implantable cardioverter-defibrillator

Efficacy and safety of the subcutaneous implantable cardioverter defibrillator: a systematic review

“…This significantly reduces rates of IAS 47. In the IDE study, dual zone programming reduced the 2-year IAS rate from 26.4% to 10.3% 48. Consequently, Burke et al reported a 34% decrease in 6-month incidence of IAS from the first quartile of patients enrolled into their combined registry compared with the last 6.…”

Subcutaneous Implantable Cardioverter-Defibrillator Shock: Appropriate or Inappropriate?

“…rate, onset, stability, and atrioventricular relationship), after which morphology-based discrimination is applied, the S-ICD system initially analyzes the morphological characteristics of the electrogram recorded by the device to determine the presence of an arrhythmia. 1 The S-ICD system evaluates up to 41 fiduciary points of each ventricular complex in order to accurately discriminate VT from SVT. The sensitivity of ventricular arrhythmia detection by S-ICD has been shown to be equivalent to transvenous ICD systems, and the specificity for SVT may be significantly better for the S-ICD system, especially when dual-zone programming (with a conditional zone) is applied.…”

Optimal Strategies for Mitigating Sudden Cardiac Death Risk in At-risk Patients with Structural Heart Disease

“…In addition, beat-to-beat morphology variations are also examined and, based on these three parameters, the S-ICD determines whether therapy should be delivered. 36 Confirmation of a shockable rhythm is ensured separately prior to capacitor charging and shock delivery. Preimplant ECG screening with patients in different postures is crucial to identifying patients unsuited for S-ICD use, further lowering the rate of inappropriate therapy.…”