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The subcutaneous implantable cardioverter-defibrillator: A tertiary center experience
Med Univ Vienna, Dept Surg, Div Cardiac Surg, Vienna, Austria.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.ORCID iD: 0000-0001-7906-7782
Univ Appl Sci, Krems, Austria.
Med Univ Vienna, Div Cardiol, Dept Internal Med 2, Vienna, Austria.
2019 (English)In: CARDIOLOGY JOURNAL, ISSN 1897-5593, Vol. 26, no 5, p. 543-549Article in journal (Refereed) Published
Abstract [en]

Background:

The aim of the study was to evaluate subcutaneous implantable cardioverter-defibrillator (S-ICD) patients with regard to underlying etiology, peri-procedural outcome, appropriate/inappropriate shocks, and complications during follow-up.

Methods:

All patients who underwent S-ICD implantation from February 2013 to March 2017 at an academic hospital in Vienna were included. Medical records were examined and follow-up interrogations of devices were conducted.

Results:

A total of 79 S-ICD patients (582% males) with a mean age of 44.5 +/- 17.2 years were followed for a mean duration of 12.8 +/- 13.7 months. A majority of patients (582%) had S-ICD for primary prevention of sudden cardiac death. The most common of the 16 underlying etiologies were ischemic cardiomyopathy, non-ischemic cardiomyopathy, and idiopathic ventricular fibrillation. The lead was implanted to the left sternal border in 96.2% of cases, between muscular layers in 72.2%. Mean implant time was 45 min, 3 patients were induced, and all patients except one were programmed to two zones. Six (7.6%) patients experienced at least one appropriate therapy for ventricular arrhythmias and the time to first event ranged from 1 to 52 months. Seven patients experienced inappropriate shocks due to T-wave oversensing, atrial tachycardia with rapid atrioventricular conduction, external electromagnetic interference, and/or baseline oversensing due to lead movement. Four patients underwent revision for lead repositioning (n = 1), loose device suture (n = 1), and infection (n = 2).

Conclusions:

While S-ICDs are a feasible and effective treatment, issues remain with inappropriate shock and infection.

Place, publisher, year, edition, pages
2019. Vol. 26, no 5, p. 543-549
Keywords [en]
arrhythmia, complication, subcutaneous implantable cardioverter-defibrillator, sudden cardiac death
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-397958DOI: 10.5603/CJ.a2018.0050ISI: 000496719900015PubMedID: 29718532OAI: oai:DiVA.org:uu-397958DiVA, id: diva2:1382202
Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-01-02Bibliographically approved

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