Who Should Receive the Subcutaneous Implanted Defibrillator?

Rav, Moshe; Milan, David J.

doi:10.1161/circep.113.000445

Cited by 13 publications

(8 citation statements)

References 30 publications

(28 reference statements)

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“…Concerns have been raised regarding the more prolonged detection and charge times seen in a proportion of S-ICD patients versus standard ICD systems. On average standard ICD times to detection and shock therapy are approximately 5 seconds shorter [16]. However, as discussed later these delayed detection and charge times may actually help reduce unnecessary shocks due to self-termination of VT/VF and even be a factor in reducing mortality in ICD recipients.…”

Section: Induced Vfmentioning

confidence: 99%

“…In the S-ICD IDE trial, the time to therapy for appropriate shocks was 14.6 ± 2.9 s which is within the range of prolongation in detection shown to be beneficial in MADIT-RIT. However, debate continues regarding the risk versus benefits of prolonged detection facilitating self-termination of VT/VF episodes and potentially reduced mortality from unnecessary ATP and shocks versus a potentially higher risk of syncope or avoiding shocks through pace termination of VT [16]. Of note however, in the ALTITUDE Registry, there was a recognised increase in mortality for patients receiving ATP accelerating VT (hazard ratio, 3.03; 95 % confidence interval, 2.65–3.46) [30].…”

Section: Limitations Of the S-icd: Bradycardia Pacing And Anti-tachycmentioning

confidence: 99%

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Early Experience with the Subcutaneous ICD

Lambiase

Srinivasan

2014

Curr Cardiol Rep

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The Subcutaneous Internal Cardiac Defibrillator (S-ICD) represents a major advance in the care of patients who have an indication for an internal cardiac defibrillator without pacing indications. Its main advantage is that it can deliver a shock to cardiovert ventricular arrhythmias utilising a tunnelled subcutaneous lead, negating the risks associated with conventional transvenous systems. Initial studies have shown comparable efficacy in cardioversion of induced and spontaneous ventricular tachycardia (VT) and ventricular fibrillation (VF) when compared to conventional transvenous systems. In addition, inappropriate shocks occurred in a similar percentage of patients to conventional ICD studies. Complication rates are low and relate largely to localised wound infections, treated successfully with antibiotics. The long term efficacy of the device is yet to be ascertained, however, a randomised trial & prospective registries are currently in progress to enable direct comparison with transvenous ICDs. This article summarises the early clinical experience and trials in the implantation of the S-ICD.

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Section: Induced Vfmentioning

confidence: 99%

Section: Limitations Of the S-icd: Bradycardia Pacing And Anti-tachycmentioning

confidence: 99%

Early Experience with the Subcutaneous ICD

Lambiase

Srinivasan

2014

Curr Cardiol Rep

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“…Disadvantages of the present system include: absence of pacing for bradycardia, resynchronization or tachycardia termination, inadequate sensing in ~10% of patients, large size of the generator, undesirable cosmetics, and cost 15 . For these reasons, some centers restrict the device to select patients who have poor vascular status, are at high risk for intravascular infection, or young patients receiving primary prevention devices who are at particularly high risk of complications from intravascular of leads 16 ; other centers are more liberal in their apporach 17 . These systems will evolve.…”

Section: Diagnostic Strategiesmentioning

confidence: 99%

The Future of Arrhythmias and Electrophysiology

Albert

Stevenson

2016

Circulation

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“…VF with very low amplitude waves); prolonged time to therapy compared with transvenous ICD (14-18” vs. 7-8”); shock efficacy on spontaneous clinical VT/VF [22, 26]. Until now, there are still relatively few data regarding long term performance of the S-ICD in a “real world” scenario so larger experience and longer follow up are required, but initial results are encouraging [19-21].…”

Section: S-icd: An Overviewmentioning

confidence: 99%

The Entirely Subcutaneous Defibrillator (S-Icd): State of the Art and Selection of the Ideal Candidate

Maria

Olaru²,

Cappelli³

2014

CCR

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The traditional transvenous defibrillator has been one of the greatest advancement in Cardiology in the last 30 years and has demonstrated to reduce arrhythmic and total mortality in selected patients. However the traditional defibrillator can have a high price to pay in terms of complications, the “weakest link” being the transvenous/endocardial leads. The entirely subcutaneous defibrillator (S-ICD) has recently entered into the clinical scenario and represents a valid alternative to the transvenous device. S-ICD can provide substantial advantages, especially among some subgroups of patients (i.e. after device infection, in young patients and arrhythmogenic syndromes). However, given its characteristics, it is fundamental to choose patients that can benefit the most. In this review we will describe advantages and limitations of the S-ICD and point-out how to select the “ideal candidate” for the implantation.

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Who Should Receive the Subcutaneous Implanted Defibrillator?

Cited by 13 publications

References 30 publications

Early Experience with the Subcutaneous ICD

Early Experience with the Subcutaneous ICD

The Future of Arrhythmias and Electrophysiology

The Entirely Subcutaneous Defibrillator (S-Icd): State of the Art and Selection of the Ideal Candidate

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