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Dijkshoorn LA, Smeding L, Pepplinkhuizen S, de Veld JA, Knops RE, Olde Nordkamp LRA. Fifteen years of subcutaneous implantable cardioverter-defibrillator therapy: Where do we stand, and what will the future hold? Heart Rhythm 2024:S1547-5271(24)02741-3. [PMID: 38908460 DOI: 10.1016/j.hrthm.2024.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/24/2024]
Abstract
The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as a feasible alternative for the transvenous ICD in the treatment of ventricular tachyarrhythmias in patients without pacing or cardiac resynchronization therapy indications. Since its introduction, numerous innovations have been made and clinical experience was gained leading to its adoption in current practice and preference in certain populations. Moreover, emerging technologies like the extravascular ICD or the combination of the S-ICD with the leadless pacemaker offer new possibilities for the future. These advancements underscore the S-ICD's evolving role in ventricular tachyarrhythmia management. This review outlines implantation considerations, patient selection and troubleshooting advancements in the last 15 years and also provides insights into future perspectives.
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Affiliation(s)
- L A Dijkshoorn
- Department of Cardiology, Amsterdam UMC, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands
| | - L Smeding
- Department of Cardiology, Amsterdam UMC, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands
| | - S Pepplinkhuizen
- Department of Cardiology, Amsterdam UMC, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands
| | - J A de Veld
- Department of Cardiology, Amsterdam UMC, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands
| | - R E Knops
- Department of Cardiology, Amsterdam UMC, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands
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Lüker J, Strik M, Andrade JG, Raymond-Paquin A, Elrefai MH, Roberts PR, Pérez ÓC, Kron J, Koneru J, Franqui-Rivera H, Sultan A, Ernst A, Schmitt J, Pott A, Veltmann C, Srinivasan NT, Collinson J, van Stipdonk AMW, Linz D, Fluschnik N, Tönnis T, Haeberlin A, Ploux S, Steven D. Incidence of premature battery depletion in subcutaneous cardioverter-defibrillator patients: insights from a multicenter registry. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01468-1. [PMID: 36652082 DOI: 10.1007/s10840-023-01468-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND The subcutaneous ICD established its role in the prevention of sudden cardiac death in recent years. The occurrence of premature battery depletion in a large subset of potentially affected devices has been a cause of concern. The incidence of premature battery depletion has not been studied systematically beyond manufacturer-reported data. METHODS Retrospective data and the most recent follow-up data on S-ICD devices from fourteen centers in Europe, the US, and Canada was studied. The incidence of generator removal or failure was reported to investigate the incidence of premature S-ICD battery depletion, defined as battery failure within 60 months or less. RESULTS Data from 1054 devices was analyzed. Premature battery depletion occurred in 3.5% of potentially affected devices over an observation period of 49 months. CONCLUSIONS The incidence of premature battery depletion of S-ICD potentially affected by a battery advisory was around 3.5% after 4 years in this study. Premature depletion occurred exclusively in devices under advisory. This is in line with the most recently published reports from the manufacturer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04767516 .
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Affiliation(s)
- Jakob Lüker
- Department of Electrophysiology, University of Cologne, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Marc Strik
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac-, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-, Bordeaux, France
| | - Jason G Andrade
- Center for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada
- Montreal Heart Institute, Université de Montréal, Québec, Canada
| | | | - Mohamed Hassan Elrefai
- Division of Cardiology, University Hospital Southampton NHS Foundation Hospital Trust, Southampton, UK
| | - Paul R Roberts
- Division of Cardiology, University Hospital Southampton NHS Foundation Hospital Trust, Southampton, UK
| | - Óscar Cano Pérez
- Unidad de Arritmias, Área de Enfermedades Cardiovasculares, Hospital Universitari i Politècnic La Fe Valencia, and Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares, Madrid, Spain
| | - Jordana Kron
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA
| | - Jayanthi Koneru
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA
| | - Hilton Franqui-Rivera
- Department of Medicine, Cardiovascular Disease Division, University of Puerto Rico, San Juan, Puerto Rico, 00936, USA
| | - Arian Sultan
- Department of Electrophysiology, University of Cologne, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Angela Ernst
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Jörn Schmitt
- Medizinische Klinik I, Abteilung für Kardiologie, Universitätsklinikum Gießen, Gießen, Germany
| | - Alexander Pott
- Department of Internal Medicine II, Ulm University Medical Center, Albert-Einstein-Allee, 23, Ulm, Germany
| | | | - Neil T Srinivasan
- Department of Cardiac Electrophysiology, Essex Cardiothoracic Centre, Basildon, UK
- Circulatory Health Research Group, Medical Technology Research Centre, School of Medicine, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK
| | - Jason Collinson
- Department of Cardiac Electrophysiology, Essex Cardiothoracic Centre, Basildon, UK
| | - Antonius M W van Stipdonk
- Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Dominik Linz
- Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Nina Fluschnik
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Tönnis
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Haeberlin
- Department of Cardiology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Sylvain Ploux
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac-, Bordeaux, France
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-, Bordeaux, France
| | - Daniel Steven
- Department of Electrophysiology, University of Cologne, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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Leo M, Sharp AJ, Gala ABE, Pope MTB, Betts TR. Transvenous or subcutaneous implantable cardioverter defibrillator: a review to aid decision-making. J Interv Card Electrophysiol 2022:10.1007/s10840-022-01299-6. [PMID: 35835888 DOI: 10.1007/s10840-022-01299-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/06/2022] [Indexed: 01/08/2023]
Abstract
The implantable cardioverter-defibrillator (ICD) is a proven treatment for preventing sudden cardiac death. Transvenous leads are associated with significant mortality and morbidity, and the subcutaneous ICD (S-ICD) addresses this. However, it is not without limitations, in particular the absence of anti-tachycardia pacing. The decision of which device is most suitable for an individual patient is often complex. Here, we review the relative merits and weaknesses of both the transvenous and S-ICD. We summarise the available evidence for each device in particular patient cohorts, namely: ischaemic and non-ischaemic cardiomyopathy, idiopathic ventricular fibrillation, Brugada syndrome, long QT syndrome, arrhythmogenic right ventricular cardiomyopathy, and hypertrophic cardiomyopathy.
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Affiliation(s)
- Milena Leo
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alexander J Sharp
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Andre Briosa E Gala
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Michael T B Pope
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Timothy R Betts
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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