Studies have demonstrated overall prognostic benefits of ICD implantation in patients at increased risk of sudden cardiac death. However, results are inconsistent in certain subgroups. This study aims to evaluate the prognostic implications of comorbidities on ICD outcomes and compare trends in patient selection and outcomes over a decade-long inclusion period. This study analysed 422 patients undergoing ICD implantation between 2011 and 2020. The study endpoint "no-benefit" was characterized by death from any cause occurring without prior appropriate ICD therapy. Benefit of ICD implantation was defined as either receiving appropriate ICD therapy before death or surviving until the end of the observation period. During a mean follow-up of 4.2 ± 3.0 years, no-benefit of ICD implantation was observed in 84 patients (20%). Independent risk factors for no-benefit were age ≥ 68 years (HR 4.599, p < 0.001), anemia (HR 2.549, p < 0.001), peripheral artery disease (HR 2.066, p = 0.007), and chronic obstructive pulmonary disease (HR 1.939, p = 0.014). Subgroup analysis by age < 68 years and ≥ 68 years demonstrated that the risk of no-benefit increases with age and comorbidities. When comparing patients with ICD implantation in 2011-2015 with those in 2016-2020, there were no significant differences in one-, two- and three-year-no-benefit rates. Different comorbidities were associated with no-benefit in the early and late implantation groups. Risk factors such as older age and specific comorbidities are associated with a higher likelihood of no-benefit from ICD implantation. A careful patient selection and consideration of individual risk factors besides advanced age is important.
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http://dx.doi.org/10.1038/s41598-025-86022-x | DOI Listing |
Europace
January 2025
Institute of Cardiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy.
Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an alternative to traditional ICDs. The PRAETORIAN score, based on chest radiographs, has been validated to predict the probability of successful S-ICD defibrillation testing by assessing factors like fat thickness between the coil and sternum and generator placement.
Objective: This study evaluated the correlation between the PRAETORIAN score and clinical characteristics, as well as implantation variables.
Sci Rep
January 2025
Department of Cardiology and Rhythmology, St. Josef-Hospital of the Ruhr University Bochum, Gudrunstraße 56, 44791, Bochum, Germany.
Studies have demonstrated overall prognostic benefits of ICD implantation in patients at increased risk of sudden cardiac death. However, results are inconsistent in certain subgroups. This study aims to evaluate the prognostic implications of comorbidities on ICD outcomes and compare trends in patient selection and outcomes over a decade-long inclusion period.
View Article and Find Full Text PDFHeart
January 2025
The Capital Region's Unit for Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Background: Treatment with implantable cardioverter-defibrillators (ICDs) effectively prevents sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). Identifying patients most likely to benefit from a primary prevention ICD remains challenging. We aimed to investigate the long-term incidence of ICD therapy in patients with HCM according to SCD-risk at baseline.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesia and Perioperative Medicine, University of California Los Angeles (UCLA) David Geffen School of Medicine, UCLA Health System, Los Angeles, California.
Management of refractory ventricular fibrillation (VF) in patients with implantable implantable cardioverter defibrillator (ICD) presents a therapeutic challenge. We present a case of pediatric refractory ventricular tachycardia (VT)/Torsade de Pointe managed effectively with bilateral stellate ganglion block (SGB) with a long-acting local anesthetic for 18 days as a bridge to more definitive surgical management.
View Article and Find Full Text PDFJ Interv Card Electrophysiol
January 2025
Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences Heart Failure & Arrhythmias, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
Background: Little data exists regarding the optimal antithrombotic strategy during S-ICD implantation to prevent pocket hematomas. This study explores the association between perioperative antithrombotic management and the occurrence of pocket hematoma following S-ICD implantation.
Methods: All patients who underwent de novo S-ICD implantation between February 2009 and January 2023 at Amsterdam UMC were included.
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