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Feasibility of entirely subcutaneous ICD™ systems in patients with coronary artery disease

Published on Nov 1, 2019in Clinical Research in Cardiology4.907
· DOI :10.1007/s00392-019-01455-5
Kevin Willy2
Estimated H-index: 2
,
Markus Bettin5
Estimated H-index: 5
+ 7 AuthorsGerrit Frommeyer18
Estimated H-index: 18
Abstract
Background The subcutaneous ICD (S-ICD™) is an important advance in device therapy for the prevention of sudden cardiac death (SCD). Although current guidelines recommend S-ICD™ use, long-term data are still limited, especially in subgroups. Among several cardiac diseases that prone to SCD, coronary artery disease (CAD) carries several peculiarities that may hamper S-ICD™ therapy in this cohort. CAD can lead to an ischemic cardiomyopathy (ICM) with a reduced left-ventricular ejection fraction (LVEF) and bundle branch blocks, which can be difficult for ICD sensing and discrimination of arrhythmia. CAD is mainly driven by risk factors such as diabetes mellitus, which put these patients at an elevated risk for infectious complications of cardiac devices. Furthermore, in ICM myocardial scars are frequent and are a potential substrate for ventricular tachycardia, which may be accessible for antitachycardia pacing. At the moment, it remains unclear if there is a value of S-ICD™ therapy in this subgroup. Therefore, this study analysed patients with CAD.
  • References (22)
  • Citations (3)
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References22
Newest
#1Markus BettinH-Index: 5
#2Benjamin RathH-Index: 3
Last. Gerrit FrommeyerH-Index: 18
view all 8 authors...
Background The subcutaneous ICD is a promising treatment option in patients at risk for sudden cardiac death. Approved in 2009, the first S-ICD® in Germany was implanted in June 2010. Although large prospective registry studies have shown safety and efficacy of the system, there is a lack of long-term data with regard to battery longevity of the S-ICD®. Therefore, we report follow-up of our first initial S-ICD® cases from implantation till battery depletion.
6 CitationsSource
#1Tom F. Brouwer (UvA: University of Amsterdam)H-Index: 13
#2Reinoud E. Knops (UvA: University of Amsterdam)H-Index: 24
Last. Jeff S. Healey (Population Health Research Institute)H-Index: 62
view all 10 authors...
Aims: Comparison of outcomes between subcutaneous and transvenous implantable cardioverter-defibrillator (S-ICD and TV-ICD) therapy is hampered by varying patient characteristics and complication definitions. The aim of this analysis is to compare clinical outcomes of S-ICD and TV-ICD therapy in a matched cohort. // Methods and results: Patients implanted with de novo implantable cardioverter-defibrillators without need for pacing were selected from two studies: SIMPLE (n = 1091 single and n = 5...
11 CitationsSource
#1Anne-Floor B.E. Quast (UvA: University of Amsterdam)H-Index: 4
Last. Reinoud E. Knops (UvA: University of Amsterdam)H-Index: 24
view all 7 authors...
Introduction: Experience with the subcutaneous implantable cardioverter-defibrillator (S-ICD) is expanding rapidly. However, data on long-term performance or complications related to elective generator replacement are lacking. Methods: Follow-up (FU) data of all patients implanted between December 2008 and April 2011 were collected. Complications were defined as those requiring surgical intervention. Kaplan-Meier estimates for complication and shock rates, with corresponding 95% confidence inter...
9 CitationsSource
#1Bart A. Mulder (UG: University of Groningen)H-Index: 7
#2Alexander H. Maass (UG: University of Groningen)H-Index: 20
Last. Yuri Blaauw (UG: University of Groningen)H-Index: 13
view all 3 authors...
3 CitationsSource
#1Darren Mylotte (MUHC: McGill University Health Centre)H-Index: 19
#2Dinela Rushani (McGill University)H-Index: 4
Last. Ariane J. Marelli (McGill University)H-Index: 32
view all 10 authors...
Congenital heart disease (CHD) increases the risk of infective endocarditis (IE), though the lesion-specific risk and mortality are poorly defined. Using the population-based Quebec CHD database, we sought to describe the predictors of IE and to evaluate if IE was associated with mortality among adult CHD (ACHD) patients without prior valve replacement surgery. We extracted data on ACHD patients with IE and assessed the lesion-specific incidence of IE, risk factors for IE acquisition, and all-ca...
6 CitationsSource
#1Lucas V.A. BoersmaH-Index: 34
#2Craig S. Barr (Russells Hall Hospital)H-Index: 17
Last. Pier D. LambiaseH-Index: 29
view all 14 authors...
Abstract Background The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to defibrillate ventricular arrhythmias, avoiding drawbacks of transvenous leads. The global EFFORTLESS S-ICD (Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD) registry is collecting outcomes in 985 patients during a 5-year follow-up. Objectives The primary goal of the EFFORTLESS registry is to determine the safety of the S-ICD by evaluating complications and ina...
67 CitationsSource
#1Julia KöbeH-Index: 19
Last. Lars EckardtH-Index: 35
view all 9 authors...
Background For prevention of sudden cardiac death, the transvenously implantable cardioverter-defibrillator therapy (tv-ICD) is well accepted. The subcutaneous system (S-ICD®) is promising in terms of reducing ICD complications. Nevertheless, the impact of the novel generator position on patients’ quality of life (QoL) is yet unknown.
18 CitationsSource
#1Lucas V.A. BoersmaH-Index: 34
#2Craig S. BarrH-Index: 17
Last. Michael R. Gold (MUSC: Medical University of South Carolina)H-Index: 47
view all 13 authors...
Background The subcutaneous implantable defibrillator (S-ICD) provides an alternative to the transvenous ICD for the prevention of sudden cardiac death, but has not been well studied in the most commonly treated transvenous ICD patient population, namely, primary prevention (PP) patients with left ventricular dysfunction. Objective The analyses in the present study were designed to compare clinical outcomes for PP patients with and without a reduced ejection fraction (EF) and secondary preventio...
17 CitationsSource
#1Maria João Sousa (John Radcliffe Hospital)H-Index: 1
#2Timothy R. Betts (John Radcliffe Hospital)H-Index: 22
Abstract The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel technology with proven efficacy in sudden cardiac death prevention; however, there is a lack of long-term safety data. We describe the case of a 55-year-old female patient implanted with an S-ICD due to idiopathic ventricular fibrillation, who subsequently presented with inappropriate shocks leading to ventricular fibrillation that was successfully terminated by another shock. Inappropriate shocks were due to int...
2 CitationsSource
#1Reinoud E. Knops (AMC: Academic Medical Center)H-Index: 4
#2Tom F. Brouwer (AMC: Academic Medical Center)H-Index: 13
Last. Martin C. Burke Do (U of C: University of Chicago)H-Index: 23
view all 16 authors...
Aims The subcutaneous implantable cardioverter defibrillator (S-ICD) was introduced to overcome complications related to transvenous leads. Adoption of the S-ICD requires implanters to learn a new implantation technique. The aim of this study was to assess the learning curve for S-ICD implanters with respect to implant-related complications, procedure time, and inappropriate shocks (IASs). Methods and results In a pooled cohort from two clinical S-ICD databases, the IDE Trial and the EFFORTLESS ...
52 CitationsSource
Cited By3
Newest
#1Kevin WillyH-Index: 2
#2Florian ReinkeH-Index: 11
Last. Gerrit FrommeyerH-Index: 18
view all 6 authors...
Background The subcutaneous ICD (S-ICD™) is an important advance in device therapy for prevention of sudden cardiac death (SCD). In some patients, decision pro- or contra-ICD implantation is particularly challenging due to inconsistent data on risk of ventricular tachyarrhythmias or sudden cardiac death, rare entities, special medical or family history, or patients’ wishes. Whether decision-making in these borderline cases has been facilitated with the new option of a S-ICD™ is unknown.
2 CitationsSource
#1Kevin WillyH-Index: 2
#2Florian ReinkeH-Index: 11
Last. Gerrit FrommeyerH-Index: 18
view all 9 authors...
Background The performance of the subcutaneous ICD (S-ICD™) has been described in different kinds of heart disease and has been proven to be an important advance in prevention of sudden cardiac death (SCD). While positive experiences with the S-ICD™ initially came from collectives of patients without structural heart diseases, positive results have also been collected from cohorts with structural heart disease.
Source
BACKGROUND: Cardiovascular magnetic resonance (CMR) studies in patients with implanted cardioverter/defibrillators (ICD) are increasingly required in daily clinical practice. However, the clinical experience regarding the feasibility as well as clinical value of CMR studies in patients with subcutaneous ICD (S-ICD) is still limited. Besides safety issues, image quality and analysis can be impaired primarily due the presence of image artefacts associated with the generator. METHODS: Twenty-three ...
Source
#1Gerrit Frommeyer (WWU: University of Münster)H-Index: 18
#2Florian Reinke (WWU: University of Münster)H-Index: 11
Last. Lars Eckardt (WWU: University of Münster)H-Index: 35
view all 11 authors...
Background Implantable cardioverter- defibrillator (ICD) therapy is established for the prevention of sudden cardiac death (SCD) in different entities. However, data from large patient cohorts with electrical heart disease are rare. Therefore, we investigated these patients as well as patients with hypertrophic cardiomyopathy by analyzing registry data from a multi-center ‘real-life’ registry.
4 CitationsSource
#1T. Deneke (Rhön-Klinikum)
#2R.F. BoschH-Index: 4
Last. Thomas M. Helms (UCSF: University of California, San Francisco)H-Index: 10
view all 8 authors...
Der tragbare Defibrillator (WCD, Defibrillatorweste) ist eine temporar einsetzbare, nichtinvasive Option zur Rhythmusdetektion und Therapie bei Patienten mit erhohtem Risiko fur das Auftreten von lebensbedrohlichen ventrikularen Tachyarrhythmien (VT/VF)/plotzlichem Herztod (PHT). Ziel dieses Positionspapiers ist es, vor dem Hintergrund der aktuellen Datenlage eine Bewertung der Indikationen zum WCD vorzunehmen. Der WCD ist eine effektive Therapie zur Pravention des PHT, bedingt durch anhaltende ...
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