TY - JOUR
T1 - Significantly less inappropriate shocks in ischemic patients compared to non-ischemic patients
T2 - The S-ICD experience of a high volume single-center
AU - Oosterwerff, Erik
AU - Adiyaman, Ahmet
AU - Elvan, Arif
AU - Ghani, Abdul
AU - Hoek, Lennaert
AU - Breeman, Karel
AU - Smit, Jaap Jan
AU - Ramdat Misier, Anand
AU - Delnoy, Peter Paul
N1 - Publisher Copyright: © 2021 Wiley Periodicals LLC
PY - 2021/11
Y1 - 2021/11
N2 - Background: The subcutaneous cardioverter-defibrillator (S-ICD) continues to be preferentially used in relatively young patients, with less advanced heart disease. Objective: We, therefore, studied the short and long-term efficacy and safety of the S-ICD in subgroups of patients, which are underreported at present. Methods: A total of 218 patients between November 2010 and February 2019 undergoing S-ICD with a follow up of at least 6 months implantation were included in a prospective registry. Mean follow up was 38 months. Results: The most common indication for S-ICD implantation was ischemic cardiomyopathy (n = 106, 49%). Complication rate needing invasive intervention was 9% (n = 21). Appropriate shock rate in patients with an S-ICD was 3.5%/year. A total of 30 inappropriate shocks (IAS) occurred in 19 patients (8.7%; 2.7%/year). The proportion of appropriate and inappropriate shock rates in patients with different cardiomyopathies shows remarkable variances. There were significant more IAS (3.6%/year vs. 1.7%/year, p =.048) in patients with non-ischemic cardiomyopathy versus patients with ischemic cardiomyopathy. Multivariate analysis identified, besides type of cardiomyopathy, atrial fibrillation (AF) as predictor for IAS. Conclusion: In this real-world prospective registry we analyzed S-ICD performance in the more traditional ICD patient. Patients with ischemic cardiomyopathy had significantly less inappropriate therapy compared to patients with non-ischemic cardiomyopathy and appear to be appropriate patients for this type of device.
AB - Background: The subcutaneous cardioverter-defibrillator (S-ICD) continues to be preferentially used in relatively young patients, with less advanced heart disease. Objective: We, therefore, studied the short and long-term efficacy and safety of the S-ICD in subgroups of patients, which are underreported at present. Methods: A total of 218 patients between November 2010 and February 2019 undergoing S-ICD with a follow up of at least 6 months implantation were included in a prospective registry. Mean follow up was 38 months. Results: The most common indication for S-ICD implantation was ischemic cardiomyopathy (n = 106, 49%). Complication rate needing invasive intervention was 9% (n = 21). Appropriate shock rate in patients with an S-ICD was 3.5%/year. A total of 30 inappropriate shocks (IAS) occurred in 19 patients (8.7%; 2.7%/year). The proportion of appropriate and inappropriate shock rates in patients with different cardiomyopathies shows remarkable variances. There were significant more IAS (3.6%/year vs. 1.7%/year, p =.048) in patients with non-ischemic cardiomyopathy versus patients with ischemic cardiomyopathy. Multivariate analysis identified, besides type of cardiomyopathy, atrial fibrillation (AF) as predictor for IAS. Conclusion: In this real-world prospective registry we analyzed S-ICD performance in the more traditional ICD patient. Patients with ischemic cardiomyopathy had significantly less inappropriate therapy compared to patients with non-ischemic cardiomyopathy and appear to be appropriate patients for this type of device.
KW - arrhythmia
KW - heart failure
KW - implantable cardioverter-defibrillator
KW - primary prevention
KW - subcutaneous ICD
KW - sudden cardiac death
KW - ventricular arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=85115424670&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/pace.14364
DO - https://doi.org/10.1111/pace.14364
M3 - Article
C2 - 34523140
SN - 0147-8389
VL - 44
SP - 1918
EP - 1924
JO - Pacing and clinical electrophysiology
JF - Pacing and clinical electrophysiology
IS - 11
ER -