AIMS: Assess subcutaneous implantable cardioverter-defibrillator (S-ICD) effectiveness in the prevention of sudden cardiac death and the impact of demographics and the initial detection algorithm in the delivery of inappropriate shocks (safety). METHODS: Real world prospective registry in which we assessed 54 patients (40±17years old, 85% males) who underwent S-ICD implantation for primary or secondary prevention of SCD. Safety and efficacy outcomes were defined as the delivery of inappropriate shocks and the prevention of sudden cardiac death, respectively. Tiered-therapy S-ICD had at least two programmed zones, determined by the longest RR interval. RESULTS: During a mean follow-up of 2.6±1.9years, 6 patients (11%) died, none due to sudden cardiac death. Six patients (11%) received appropriate therapies, irrespectively of the established detection algorithm (p=0.59). All ventricular tachycardia and fibrillation episodes were adequately treated. Nine patients (17%) had inappropriate shocks: 6 without tiered-therapy vs 3 with previously programmed tiered-therapy (p=0.001). The yearly rate of inappropriate shocks was 17%/year with single zone detection vs 4%/year with tiered-therapy programming (p=0.007). Single-zone detection programming was an independent predictor of inappropriate shock delivery (HR 1.49, IC 95%: 1.05-18.80, p=0.04). CONCLUSION: In this selected population of patients, the S-ICDs proved effective in preventing sudden cardiac death. Tiered-therapy was independently associated with a lower rate of inappropriate shock delivery. Copyright Â
AIMS: Assess subcutaneous implantable cardioverter-defibrillator (S-ICD) effectiveness in the prevention of sudden cardiac death and the impact of demographics and the initial detection algorithm in the delivery of inappropriate shocks (safety). METHODS: Real world prospective registry in which we assessed 54 patients (40±17years old, 85% males) who underwent S-ICD implantation for primary or secondary prevention of SCD. Safety and efficacy outcomes were defined as the delivery of inappropriate shocks and the prevention of sudden cardiac death, respectively. Tiered-therapy S-ICD had at least two programmed zones, determined by the longest RR interval. RESULTS: During a mean follow-up of 2.6±1.9years, 6 patients (11%) died, none due to sudden cardiac death. Six patients (11%) received appropriate therapies, irrespectively of the established detection algorithm (p=0.59). All ventricular tachycardia and fibrillation episodes were adequately treated. Nine patients (17%) had inappropriate shocks: 6 without tiered-therapy vs 3 with previously programmed tiered-therapy (p=0.001). The yearly rate of inappropriate shocks was 17%/year with single zone detection vs 4%/year with tiered-therapy programming (p=0.007). Single-zone detection programming was an independent predictor of inappropriate shock delivery (HR 1.49, IC 95%: 1.05-18.80, p=0.04). CONCLUSION: In this selected population of patients, the S-ICDs proved effective in preventing sudden cardiac death. Tiered-therapy was independently associated with a lower rate of inappropriate shock delivery. Copyright Â