Early Use of the Subcutaneous Implantable Cardioverter Defibrillator in the United States: A Report From the National Cardiovascular Data Registry

Efficacy and safety of the subcutaneous implantable cardioverter defibrillator: a systematic review

“…Implantation time was comparable at 71 min for the S-ICD and 65 min for a single-chamber TV-ICD 18. Length of hospital stay was also comparable (1.1 days for the S-ICD vs 1.0 days for a single chamber ICD and 1.2 days for a dual-chamber ICD) 14. There were 18 lead revisions in the TV-ICD group compared with two in the S-ICD group.…”

“…Study size ranged from 18 to 3717 subjects, with a total of 5380 patients undergoing S-ICD implantation (table 1). The largest analysis of 3717 patients was from the National Cardiovascular Data Registry, reporting inhospital outcomes for S-ICD implantation in the USA 14. The second largest study of 889 participants was an international pooled analysis of subjects recruited into the IDE (S-ICD system Investigational Device Exemption Clinical Study) and EFFORTLESS trials, reporting follow-up data to 2 years 11…”

“…Most (1920) of these patients were from a US propensity-matched cohort comparing inhospital outcomes 14. There were more pericardial effusions (6 vs 0), cardiac perforations (3 vs 0) and pneumothoraces (8 vs 0) in the TV-ICD group but fewer haematomas (3 vs 9).…”

Inappropriate shocks in a patient with a subcutaneous implantable cardioverter-defibrillator

“…The subcutaneous implantable cardioverter-defibrillator (ICD) is becoming more widespread 1 . Approved by the Food and Drug Administration for use in the United Stated in 2012, the subcutaneous ICD is now being implanted for primary and secondary prevention of sudden cardiac death among individuals meeting conventional ICD implantation criteria but who do not have an indication for cardiac resynchronization therapy or permanent bradycardia pacing, a preexisting unipolar pacemaker, or recurrent ventricular tachycardia that responds to antitachycardia pacing 2, 3, 4.…”

“…The subcutaneous implantable cardioverter-defibrillator (ICD) is becoming more widespread. 1 Approved by the Food and Drug Administration for use in the United Stated in 2012, the subcutaneous ICD is now being implanted for primary and secondary prevention of sudden cardiac death among individuals meeting conventional ICD implantation criteria but who do not have an indication for cardiac resynchronization therapy or permanent bradycardia pacing, a preexisting unipolar pacemaker, or recurrent ventricular tachycardia that responds to antitachycardia pacing. 2 , 3 , 4 Although it is becoming more evident that the subcutaneous ICD is particularly desirable in patients with venous access issues like those with end-stage renal disease on hemodialysis and in patients at an increased risk of infection, more data on this therapy are needed, especially in relation to long-term outcomes and how those outcomes compare with those of transvenous ICDs.…”