Extracardiac Inappropriate Shocks in Subcutaneous Implantable Cardioverter Defibrillator: Management in Emergency Department

Santomauro, Maurizio

doi:10.19080/jocct.2020.16.555941

Cited by 1 publication

(1 citation statement)

References 47 publications

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“… 47 Likewise, in a systematic review of the literature, Santomauro et al . 48 analysed the aetiology of extracardiac ISs in 2654 S-ICD patients in whom AE accounted for 23% of ISs related to oversensing of non-cardiac signals.…”

Section: Discussionmentioning

confidence: 99%

Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: a systematic review of the literature

et al. 2022

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Aims Air entrapment (AE) has been reported as a potential cause of early inappropriate shocks (ISs) following subcutaneous implantable cardioverter defibrillator (S-ICD) implantation, but a cause–effect relationship is not always evident. This systematic review aims to analyse this phenomenon concerning implantation techniques, electrogram (EGM) features, radiologic findings, and patient management. Methods and results A systematic search was conducted using PubMed, Embase, and Google Scholar databases following the PRISMA guidelines to obtain all available literature data since 2010 on S-ICD malfunctions possibly due to AE. The final analysis included 54 patients with AE as a potential cause of S-ICD malfunction. Overall, the aggregate incidence of this condition was 1.2%. Of ICD malfunctions possibly due to AE, 93% were ISs, and 95% were recorded within the first week following implantation. Radiologic diagnosis of AE was confirmed in 28% of the entire study cohort and in 68% of patients in whom this diagnostic examination was reported. At the time of device malfunction, EGMs showed artefacts, baseline drift, and QRS voltage reduction in 95, 76, and 67% of episodes, respectively. Management included ICD reprogramming or testing, no action (observation), and invasive implant revision in 57, 33, and 10% of patients, respectively. No recurrences occurred during follow-up, irrespective of management performed. Conclusions Device malfunction possibly due to AE may occur in ∼1% of S-ICD recipients. Diagnosis is strongly suggested by early occurrence, characteristic EGM features, and radiologic findings. Non-invasive management, principally device reprogramming, appears to be effective in most patients.

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Section: Discussionmentioning

confidence: 99%

Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: a systematic review of the literature

et al. 2022

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Extracardiac Inappropriate Shocks in Subcutaneous Implantable Cardioverter Defibrillator: Management in Emergency Department

Abstract: The subcutaneous implantable cardioverter defibrillator (S-ICD) is an established treatment for the prevention of sudden cardiac death. In the S-ICD studies, inappropriate shocks (IAS) rate were reported to renge between 5% to 25% and to be mainly due to cardiac and noncardiac oversensing.

Cited by 1 publication

References 47 publications

Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: a systematic review of the literature

Air entrapment as a potential cause of early subcutaneous implantable cardioverter defibrillator malfunction: a systematic review of the literature

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