Specific indications and clinical outcome in patients with subcutaneous implantable cardioverter-defibrillator (ICD) - A nationwide multicentre registry

Michael Sponder, Cesar Khazen, Wolfgang Dichtl, Lukas Fiedler, Deddo Mörtl, Alexander Teubl, Clemens Steinwender, Martin Martinek, Michael Nürnberg, Daniel Dalos, Johannes Kastner, Christoph Schukro

Research output: Journal article (peer-reviewed)Journal article

7 Citations (Scopus)

Abstract

BACKGROUND: Subcutaneous implantable cardioverter-defibrillators (S-ICD) are an innovative and less invasive alternative to transvenous ICD (TV-ICD) in selected patients. We aimed to investigate the underlying diseases and the specific indications for implanting S-ICD in clinical practice, as well as the prevalence of shock delivery and complications.

METHODS AND RESULTS: From December 2012, data of 236 patients (30,5% female; age 48,6±16,8years) were gathered from 12 centres in Austria. Follow-up data over a period of 1,7±1,1years were available for 231 patients (in total 359,2 patient-years). Predominant underlying diseases were ischemic cardiomyopathy (iCMP; 32,0%), idiopathic ventricular fibrillation (22,6%) and dilated cardiomyopathy (dCMP; 17,3%). The most frequent indications for implantation were sudden cardiac death survival (27,4%), primary prevention for iCMP (23,9%) and for dCMP (12,8%), and previous explantation of TV-ICD (12,4%). Appropriate shocks were documented in 16 patients (6,9%), iCMP being the predominant underlying disease. Arrhythmia conversion was successful in all patients, efficacy of the first shock was 96%. Inappropriate shock rate was 5,2%, predominantly caused by oversensing of T wave or artefacts. A device upgrade to an ICD system with pacing function was necessary in <1%. Clinical complications needing surgical revision occurred in 8 patients (3,5%).

CONCLUSIONS: S-ICD were mostly implanted for primary prevention, one fourth of our cases were sudden death survivors. Clinical and functional complication rate was relatively low. In conclusion, S-ICD is a safe and efficient alternative in a larger population of ICD candidates, when no cardiac pacing is needed. EC-number: C-136-17.

Original languageEnglish
Pages (from-to)64-68
Number of pages5
JournalEuropean Journal of Internal Medicine
Volume48
DOIs
Publication statusPublished - Feb 2018

Keywords

  • Adult
  • Aged
  • Austria/epidemiology
  • Death, Sudden, Cardiac/epidemiology
  • Defibrillators, Implantable
  • Equipment Failure/statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Primary Prevention
  • Registries
  • Retrospective Studies
  • Secondary Prevention
  • Treatment Outcome
  • Ventricular Fibrillation/etiology
  • Complications
  • Indications
  • Subcutaneous implantable cardioverter-defibrillator
  • Appropriate shocks
  • Inappropriate shocks
  • S-ICD

ASJC Scopus subject areas

  • Internal Medicine

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