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Inappropriate Therapy and Shock Rates Between the Subcutaneous and Transvenous Implantable Cardiac Defibrillator: A Secondary Analysis of the PRAETORIAN Trial.
Circ Arrhythm Electrophysiol
December 2024
Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences Heart failure and Arrhythmias, the Netherlands (L.R.A.O.N., S.P., L.V.A.B., T.F.B., A.-F.B.E.Q., W.v.d.S., L.S., J.A.d.V., J.G.P.T., N.R.B., J.R.d.G., K.M.K., A.d.W., A.A.M.W., R.E.K.).
Article Synopsis
- Inappropriate therapy (IAT) is a significant issue associated with implantable cardiac defibrillator (ICD) therapy, particularly highlighted in early subcutaneous ICD (S-ICD) studies which showed high rates of inappropriate shocks (IAS).
- The PRAETORIAN trial, an international study with 849 patients, found no major differences in IAT and IAS rates between S-ICD and transvenous ICD (TV-ICD) groups, as both groups had similar cumulative incidences.
- Key predictors for IAT varied between the two groups, with TV-ICD patients experiencing IAT mainly from supraventricular tachycardias, while S-ICD patients faced issues from cardiac oversensing
Failure of Ventricular Fibrillation Sensing During Subcutaneous Implantable Defibrillator Testing: A Twitchy Situation.
J Innov Card Rhythm Manag
November 2024
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Oversensing of extra-cardiac noise may inhibit delivery of subcutaneous cardiac implantable defibrillator (S-ICD) therapy. We report a case of diaphragmatic tetany resulting in the inhibition of S-ICD therapy at the time of defibrillator testing without the use of muscle relaxants. Clinicians should be aware of this phenomenon.
View Article and Find Full Text PDFAir entrapment causing ventricular oversensing early after implantation of an extravascular implantable cardioverter-defibrillator.
HeartRhythm Case Rep
September 2024
Cardiology Department, University Hospital Zurich, Zurich, Switzerland.
Performance and Safety of the Extravascular Implantable Cardioverter-Defibrillator Through Long-Term Follow-Up: Final Results From the Pivotal Study.
Circulation
September 2024
Christchurch Hospital, Christchurch, New Zealand.
Article Synopsis
- The study evaluates the long-term performance and safety of the extravascular implantable cardioverter-defibrillator (EV ICD) after initial findings showed its effectiveness for 6 months.
- A total of 316 patients were enrolled, with a successful implant in 299 cases, experiencing various arrhythmic events that were effectively treated using antitachycardia pacing (ATP) and shocks.
- The results indicated high success rates for both ATP (77.1%) and shock therapy (100%), with low rates of complications and inappropriate shocks over the three-year study period.
Long-Term Performance of Subcutaneous Implantable Defibrillators in Athletes: A Multicenter, Real-World Analysis of Sport Activities from the iSUSI Registry.
Heart Rhythm
September 2024
Cardiology Unit, Luigi Sacco University Hospital, Milan, Italy.
Article Synopsis
- The study aims to evaluate the performance and safety of subcutaneous-implantable cardioverter defibrillator (S-ICD) technology in athletes compared to nonathletes, focusing on device-related complications and shock occurrences.
- Athletes made up 10.2% of the 1493 patients studied and showed higher incidences of certain heart conditions, with a tendency to experience appropriate shocks more frequently during exercise, although this was not statistically significant after adjusting for other factors.
- Overall, S-ICDs appear to be a safe option for athletes, as there was no significant difference in overall complications or inappropriate shocks between the two groups, though athletes had a higher risk of myopotential oversensing and lead infections shortly after implant.
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