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Budrejko S, Zienciuk-Krajka A, Daniłowicz-Szymanowicz L, Kempa M. Comparison of Preoperative ECG Screening and Device-Based Vector Analysis in Patients Receiving a Subcutaneous Implantable Cardioverter-Defibrillator. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2186. [PMID: 38138289 PMCID: PMC10745078 DOI: 10.3390/medicina59122186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) provide protection against sudden cardiac death from outside the cardiovascular system. ECG screening is a prerequisite for implantation, but the reproducibility of its results post-operatively in the device is only partial. We aimed to compare the results of ECG screening with device-based sensing vector analysis. Materials and Methods: We screened the hospital records of all S-ICD recipients in our clinic. All of them had pre-operative ECG screening performed (primary, secondary, and alternate vectors). The results were compared with device-based vector analysis to determine the relation of the pre- and post-operative vector availability. Results: Complete ECG screening and device-based vector analysis were obtained for 103 patients. At least two acceptable vectors were found in 97.1% of the patients pre-operatively and in 96.1% post-operatively. When comparing vectors in terms of agreement (OK or FAIL) pre- and post-operatively, in 89.3% of the patients, the result for the primary vector was the same in both situations; for the secondary, it was in 84.5%, and for the alternate, it was in 74.8% of patients, respectively. In 55.3% of patients, all three vectors were labeled the same (OK or FAIL); in 37.9%, two vectors had the same result, and in 6.8%, only one vector had the same result pre- and post-operatively. The number of available vectors was the same pre- and post-operatively in 62.1% of patients, while in 15.5%, it was lower, and in 22.3% of patients, it was higher than observed during screening. Conclusions: Routine clinical pre-operative screening allowed for a good selection of candidates for S-ICD implantation. All patients had at least one vector available post-operatively. The final number of vectors available in the device-based analysis in most patients was at least the same (or higher) than during screening. The repeatability of the positive result for a single vector was high.
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Affiliation(s)
- Szymon Budrejko
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Poland; (A.Z.-K.); (L.D.-S.); (M.K.)
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Sarubbi B, Ciriello GD, Papaccioli G, Correra A, Romeo E, Grimaldi N, Colonna D, Palma M. Combined subcutaneous implantable cardioverter defibrillator and pacemaker devices in complex congenital heart disease: a single-center experienced based study. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01670-1. [PMID: 37878161 DOI: 10.1007/s10840-023-01670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Subcutaneous implantable cardioverter defibrillators (S-ICD) are widely accepted therapy in congenital heart disease (CHD) patients at risk of life-threatening ventricular arrhythmias or sudden cardiac death (SCD) when pacing is not required. Occasionally, pacemaker (PM)-dependent CHD patients will subsequently develop an indication for a cardioverter defibrillator. The use of S-ICD in complex CHD patients who have had already PM devices implanted implies some specific considerations, as the safety for these patients in unknown and recommendations among physicians may vary widely. METHODS We review the data and studied the indications for S-ICD in complex CHD with previous PM and discuss its usefulness in clinical practice. RESULTS From a large cohort of 345 patients enrolled in the S-ICD Monaldi care registry, which encompass all the patients implanted in the Monaldi Hospital of Naples, we considered 11 consecutive complex CHD patients (10M/1F aged 40.4 ±18.4 years) who underwent S-ICD implant after a previous PM implant, from February 2015 to October 2022. Mean follow-up was 25.5 ± 22 months. All the patients showed a good compliance to the device system with no complications (infections or skin erosions). CONCLUSIONS In complex CHD with already implanted PM devices, S-ICD implant appears to be a safe alternative to PM upgrading to transvenous ICD system, avoiding abandoned leads or life-threatening lead extraction. However, there are important issues with regard to testing and programming that need to be addressed at the time of implantation.
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Affiliation(s)
- Berardo Sarubbi
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
| | | | | | - Anna Correra
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Emanuele Romeo
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Nicola Grimaldi
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Diego Colonna
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Michela Palma
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
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Zormpas C, Silber‐Peest AS, Eiringhaus J, Hillmann HA, Hohmann S, Müller‐Leisse J, Westhoff‐Bleck M, Veltmann C, Duncker D. Eligibility for subcutaneous implantable cardioverter-defibrillator in adults with congenital heart disease. ESC Heart Fail 2021; 8:1502-1508. [PMID: 33538124 PMCID: PMC8006645 DOI: 10.1002/ehf2.13243] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/30/2020] [Accepted: 01/19/2021] [Indexed: 01/06/2023] Open
Abstract
AIMS Patients with adult congenital heart disease (ACHD) carry an increased risk for sudden cardiac death. Implantable cardioverter-defibrillator (ICD) therapy may be challenging in these patients due to anatomical barriers, repeated cardiac surgery, or complicated transvenous access. Thus, the subcutaneous ICD (S-ICD) can be a promising alternative in this patient population. Patients with ACHD show significant electrocardiogram (ECG) abnormalities, which could affect S-ICD sensing because it depends on surface ECG. METHODS AND RESULTS One hundred patients with ACHD were screened for S-ICD eligibility. Standard ECG-based screening test and automated S-ICD screening test were performed in all patients. Sixty-six patients (66%) were male. Underlying congenital heart disease (CHD) was mainly CHD of great complexity (71%) and moderate complexity (29%), including repaired tetralogy of Fallot (20%), which was the most common entity. Thirty-seven patients (37%) already had a pacemaker (23%) or ICD (14%) implanted. Automated screening test identified 83 patients (83%) eligible for S-ICD implantation in either left parasternal position (78%) or right parasternal position (75%). Absence of sinus rhythm, QRS duration, and a paced QRS complex were associated with S-ICD screening failure in univariate analysis. Receiver operating characteristic curve and multivariate analysis revealed a QRS duration ≥148 ms as the only independent predictor for S-ICD screening failure. CONCLUSIONS Patients with ACHD show satisfactory eligibility rates (83%) for S-ICD implantation utilizing the automated screening test, including patients with CHD of high complexity. S-ICD therapy should be considered with caution in ACHD patients with a QRS duration ≥148 ms and/or need for ventricular pacing.
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MESH Headings
- Adult
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Defibrillators, Implantable
- Eligibility Determination
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/therapy
- Humans
- Male
- Patient Selection
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Affiliation(s)
- Christos Zormpas
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | | | - Jörg Eiringhaus
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | - Henrike A.K. Hillmann
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | - Stephan Hohmann
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | - Johanna Müller‐Leisse
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | | | - Christian Veltmann
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | - David Duncker
- Hannover Heart Rhythm Center, Department of Cardiology and AngiologyHannover Medical SchoolCarl‐Neuberg‐Str. 1HannoverD‐30625Germany
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
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Jing R, Jin H, Hua W, Yang S, Hu Y, Zhang S. Association Between Subcutaneous Implantable Cardioverter Defibrillator Preimplantation Screening and the Response to Cardiac Resynchronization Therapy. Korean Circ J 2020; 50:1062-1073. [PMID: 33150752 PMCID: PMC7707981 DOI: 10.4070/kcj.2019.0420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 07/26/2020] [Accepted: 08/25/2020] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives Preimplantation QRS-T morphology screening (TMS) is a composite tool for selecting subcutaneous implantable cardioverter defibrillator (S-ICD) candidates. However, its role in predicting the patient's response to cardiac resynchronization therapy (CRT) is uncertain. Methods A total of 55 consecutive de novo CRT candidates were enrolled between January 2016 and March 2017. Electrocardiogram (ECG) and TMS were performed before and soon after implantation. The ECG parameters were recorded, including QRS duration and morphology (such as ΔQRS_Index, QTc during biventricular pacing mode [BiV pacing QTc], and QRS/T ratio during biventricular pacing mode [BiV pacing QRS/T ratio]). TMS monitored three sensory vectors of the S-ICD. Six months after implantation, the responses to CRT were evaluated. Results Thirty-nine patients (70.9%) passed the TMS during biventricular pacing mode. At the six-month follow-up, the number of responders and super-responders was significantly higher in the passing group than in the non-passing group (responders: 31/39 [79.5%] vs. 5/16 [31.3%], p<0.001; super-responders: 9/39 [23.1%] vs. 1/16 [6.3%], p=0.020). The super-response rate was higher among patients who passed all three vectors than among those who passed 1 or 2 vectors (3 vs. 2 vectors, p=0.018; 3 vs. 1 vector, p=0.003). A smaller left atrial diameter, vectors that passed TMS during biventricular pacing mode, and larger ΔQRS_Index values were independently associated with good CRT response. Conclusions Our study demonstrated that patients on CRT who pass the TMS during biventricular pacing mode are more likely to respond and super-respond to CRT.
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Affiliation(s)
- Ran Jing
- The Cardiac Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Han Jin
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Wei Hua
- The Cardiac Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Shengwen Yang
- The Cardiac Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiran Hu
- The Cardiac Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu Zhang
- The Cardiac Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Adduci C, Ali H, Francia P, Mantovani R, Palano F, Lupo P, Foresti S, De Ambroggi G, Cappato R. The subcutaneous implantable cardioverter-defibrillator: Current trends in clinical practice between guidelines and technology progress. Eur J Intern Med 2019; 65:6-11. [PMID: 31005441 DOI: 10.1016/j.ejim.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/23/2019] [Accepted: 04/09/2019] [Indexed: 01/21/2023]
Abstract
The subcutaneous implantable cardioverter defibrillator (S-ICD) is a valuable alternative to the conventional trans-venous ICD (TV-ICD) for the prevention of sudden cardiac death (SCD). Prospective registries showed that the S-ICD is safe and effective in treating ventricular tachyarrhythmias in high-risk patients without pacing indications. While in earlier studies patients implanted with S-ICDs were young and mostly affected by channelopathies, contemporary S-ICD cohorts include patients with severely impaired left ventricular function and significant comorbidities. This review focuses on S-ICD evidence-based use and highlights current gaps between guidelines recommendations and real-world clinical practice.
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Affiliation(s)
- Carmen Adduci
- Department of Clinical and Molecular Medicine, Sapienza University, St Andrea Hospital, Rome, Italy.
| | - Hussam Ali
- Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy
| | - Pietro Francia
- Department of Clinical and Molecular Medicine, Sapienza University, St Andrea Hospital, Rome, Italy
| | - Riccardo Mantovani
- Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy
| | - Francesca Palano
- Department of Clinical and Molecular Medicine, Sapienza University, St Andrea Hospital, Rome, Italy
| | - Pierpaolo Lupo
- Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy
| | - Sara Foresti
- Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy
| | - Guido De Ambroggi
- Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy
| | - Riccardo Cappato
- Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy
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Bögeholz N, Willy K, Niehues P, Rath B, Dechering DG, Frommeyer G, Kochhäuser S, Löher A, Köbe J, Reinke F, Eckardt L. Spotlight on S-ICD™ therapy: 10 years of clinical experience and innovation. Europace 2019; 21:1001-1012. [DOI: 10.1093/europace/euz029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/09/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Subcutaneous ICD (S-ICD™) therapy has been established in initial clinical trials and current international guideline recommendations for patients without demand for pacing, cardiac resynchronization, or antitachycardia pacing. The promising experience in ‘ideal’ S-ICD™ candidates increasingly encourages physicians to provide the benefits of S-ICD™ therapy to patients in clinical constellations beyond ‘classical’ indications of S-ICD™ therapy, which has led to a broadening of S-ICD™ indications in many centres. However, the decision for S-ICD™ implantation is still not covered by controlled randomized trials but rather relies on patient series or observational studies. Thus, this review intends to give a contemporary update on available empirical evidence data and technical advancements of S-ICD™ technology and sheds a spotlight on S-ICD™ therapy in recently discovered fields of indication beyond ideal preconditions. We discuss the eligibility for S-ICD™ therapy in Brugada syndrome as an example for an adverse and dynamic electrocardiographic pattern that challenges the S-ICD™ sensing and detection algorithms. Besides, the S-ICD™ performance and defibrillation efficacy in conditions of adverse structural remodelling as exemplified for hypertrophic cardiomyopathy is discussed. In addition, we review recent data on potential device interactions between S-ICD™ systems and other implantable cardio-active systems (e.g. pacemakers) including specific recommendations, how these could be prevented. Finally, we evaluate limitations of S-ICD™ therapy in adverse patient constitutions, like distinct obesity, and present contemporary strategies to assure proper S-ICD™ performance in these patients. Overall, the S-ICD™ performance is promising even for many patients, who may not be ‘classical’ candidates for this technology.
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Affiliation(s)
- Nils Bögeholz
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Kevin Willy
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Philipp Niehues
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Benjamin Rath
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Dirk G Dechering
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Gerrit Frommeyer
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Simon Kochhäuser
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Andreas Löher
- Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany
| | - Julia Köbe
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Florian Reinke
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
| | - Lars Eckardt
- Division of Electrophysiology, Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
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Prevalence of subcutaneous implantable cardioverter-defibrillator based on template ECG screening and ineligible surface ECG predicting factors in patients with hypertrophic cardiomyopathy in China. Heart Vessels 2018; 34:851-859. [DOI: 10.1007/s00380-018-1300-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
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Kawabata M, Goya M, Takahashi Y, Maeda S, Yagishita A, Shirai Y, Kaneko M, Shiohira S, Hirao K. Candidacy for a Subcutaneous Implantable Cardioverter Defibrillator in Patients with Cardiac Resynchronization Therapy. Int Heart J 2018; 59:951-958. [PMID: 30101850 DOI: 10.1536/ihj.17-550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In patients requiring an implantable cardioverter defibrillator (ICD), the combined use of a prior pacemaker and a subcutaneous ICD (S-ICD) could be an alternative treatment option to implantation of new leads or upgrading of pacemakers to an ICD if vascular access is limited. Here, we assessed the prevalence of S-ICD's eligibility according to surface electrogram screening in those receiving cardiac resynchronization therapy (CRT). S-ICD's eligibility was assessed in patients with a CRT pacemaker or a CRT defibrillator using the S-ICD template screening tool. Eligibility was defined as fulfillment of the template in both supine and upright positions in one or more leads during biventricular pacing. Among 44 patients (34 men, age: 67 ± 12), 36 (82%) were found to be eligible. The T/QRS amplitude ratio in lead II was significantly lower in those who were eligible (0.31 ± 0.16 versus 0.44 ± 0.18 in the ineligible group, P = 0.04). The lead position, underlying disease, and other electrocardiographic findings were not different between those who were eligible and those who were not. The majority of patients with biventricular pacing were eligible for S-ICD based on current screening tests and may benefit from this treatment. Further study is required.
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Affiliation(s)
| | - Masahiko Goya
- Heart Rhythm Center, Tokyo Medical and Dental University
| | | | - Shingo Maeda
- Heart Rhythm Center, Tokyo Medical and Dental University
| | | | | | | | | | - Kenzo Hirao
- Heart Rhythm Center, Tokyo Medical and Dental University
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Eligibility of cardiac resynchronization therapy patients for subcutaneous implantable cardioverter defibrillators. J Interv Card Electrophysiol 2018; 54:49-54. [PMID: 30187250 DOI: 10.1007/s10840-018-0437-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Before subcutaneous implantable cardioverter defibrillator (S-ICD) implantation, the adequacy of sensing is required to be verified through surface ECG screening. Our objective was to determine whether S-ICD can be considered as a supplementary therapy in patients who are receiving biventricular (BIV) pacing. METHODS We evaluated 48 patients with BIV devices to determine S-ICD candidacy during BIV, left ventricular (LV), right ventricular (RV) pacing, and intrinsic conduction (left bundle branch block-LBBB) by using an automated screening tool. Eligibility was defined by the presence of at least one appropriate vector in the supine and standing positions. RESULTS Eligibility was verified during BIV pacing in 34 (71%) patients. In patients screened-out, QRS duration was longer (p = 0.035) and ischemic cardiomyopathy was more frequent (p = 0.027). LV-only pacing was associated with a lower passing rate (46%) (p < 0.001 versus BIV). The LBBB QRS morphology during inhibited ventricular pacing was acceptable in 51% of patients. The QRS generated by RV pacing was acceptable in 25% of patients. In patients who passed the screening test during BIV, the QRS was not acceptable in 76% during RV pacing (i.e., accidental loss of LV capture). The concomitant adequacy during inhibited ventricular pacing (i.e., possible intrinsic conduction) was not assessed in 40% of patients. CONCLUSIONS S-ICD may be a supplemental therapy in the majority of CRT patients. Standard BIV pacing should be preferred to the LV-only pacing mode, as it is more frequently associated with adequacy of S-ICD sensing. Spontaneous LBBB and RV-paced QRS morphologies are frequently inadequate. Therefore, in patients selected for concomitant S-ICD and CRT implantation, accidental loss of LV capture or possible intrinsic conduction must be prevented.
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Moubarak G, Maison-Blanche P, Thomas O. Eligibility of cardiac resynchronization therapy patients for subcutaneous implantable cardioverter defibrillators. J Electrocardiol 2017; 51:531-533. [PMID: 29273233 DOI: 10.1016/j.jelectrocard.2017.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Indexed: 10/18/2022]
Abstract
The eligibility for subcutaneous implantable cardioverter-defibrillators (S-ICD) was assessed among patients already implanted with cardiac resynchronization therapy (CRT). We included 20 patients (15 men, age 73±10years, LVEF 35±10%). Seventeen (85%) patients were eligible for S-ICDs: 11 (55%) patients on only 1 vector and 6 (30%) patients on 2 or 3 vectors. Patients who were eligible on 2-3 vectors had narrower paced QRS than patients who were not eligible or were eligible on only one vector (133±18ms vs 167±17ms, p=0.007). If necessary, S-ICD implantation could be considered in most patients with CRT.
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Affiliation(s)
- Ghassan Moubarak
- Department of Electrophysiology and Pacing, Centre Médico-Chirurgical Ambroise Paré, Neuilly-sur-Seine, France.
| | - Pierre Maison-Blanche
- Department of Electrophysiology and Pacing, Centre Médico-Chirurgical Ambroise Paré, Neuilly-sur-Seine, France
| | - Olivier Thomas
- Department of Electrophysiology and Pacing, Centre Médico-Chirurgical Ambroise Paré, Neuilly-sur-Seine, France
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RAVIELE ANTONIO, ROSSILLO ANTONIO. Combined Use of Subcutaneous ICD and Pacemakers: The Beginning of a New Era? J Cardiovasc Electrophysiol 2017; 28:549-551. [DOI: 10.1111/jce.13196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- ANTONIO RAVIELE
- ALFA-Alliance to Fight Atrial fibrillation; Venice-Mestre Italy
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