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Comparison of Preoperative ECG Screening and Device-Based Vector Analysis in Patients Receiving a Subcutaneous Implantable Cardioverter-Defibrillator. | LitMetric

AI Article Synopsis

  • Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are used to prevent sudden cardiac death, with ECG screening required before their implantation, although post-operative results can vary.
  • A study compared pre-operative ECG screening results with post-operative device-based vector analysis for 103 S-ICD recipients to assess how well the two methods agreed.
  • The findings revealed that the majority of patients maintained similar vector availability and results pre- and post-operation, suggesting that pre-operative screening is effective in selecting candidates for S-ICD implantation.

Article Abstract

: 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. : 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. : 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. : 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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10745078PMC
http://dx.doi.org/10.3390/medicina59122186DOI Listing

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