Colin Dominic Chue 1 , Chun Shing Kwok 1,2 , Chun Wai Wong 2 , Ashish Patwala 1 , Diane Barker 1 , Amir Zaidi 3 , Mamas A Mamas 1,2 , Colin Cunnington 3 , Fozia Z Ahmed 3 Show Affiliations »
Abstract
BACKGROUND: Subcutaneous implantable cardioverter defibrillators (S-ICDs) are considered an alternative to conventional transvenous ICDs (TV-ICDs) in patients not requiring pacing. METHODS: We searched MEDLINE and EMBASE for studies evaluating efficacy and safety outcomes in S-ICD patients. Outcomes were pooled across studies. RESULTS: Sixteen studies were included with 5380 participants (mean age range 33-56 years). Short-term follow-up data were available for 1670 subjects. The most common complication was pocket infection, affecting 2.7%. Other complications included delayed wound healing (0.6%) and wound discomfort (0.8%). 3.8% of S-ICDs were explanted, most commonly for pocket infection. Mortality rates in hospital (0.4%) and during follow-up (3.4% from 12 studies reporting) were low. Incidence of ventricular arrhythmia varied from 0% to 12%. Overall shock efficacy exceeded 96%. Inappropriate shocks affected 4.3% and was most commonly caused by T-wave oversensing. CONCLUSIONS: Although long-term randomised data are lacking, observational data suggest similar shock efficacy and short-term complication rates between the S-ICD and TV-ICD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
BACKGROUND: Subcutaneous implantable cardioverter defibrillators (S-ICDs ) are considered an alternative to conventional transvenous ICDs (TV-ICDs) in patients not requiring pacing. METHODS: We searched MEDLINE and EMBASE for studies evaluating efficacy and safety outcomes in S-ICD patients . Outcomes were pooled across studies. RESULTS: Sixteen studies were included with 5380 participants (mean age range 33-56 years). Short-term follow-up data were available for 1670 subjects. The most common complication was pocket infection , affecting 2.7%. Other complications included delayed wound healing (0.6%) and wound discomfort (0.8%). 3.8% of S-ICDs were explanted, most commonly for pocket infection . Mortality rates in hospital (0.4%) and during follow-up (3.4% from 12 studies reporting) were low. Incidence of ventricular arrhythmia varied from 0% to 12%. Overall shock efficacy exceeded 96%. Inappropriate shocks affected 4.3% and was most commonly caused by T-wave oversensing. CONCLUSIONS: Although long-term randomised data are lacking, observational data suggest similar shock efficacy and short-term complication rates between the S-ICD and TV-ICD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Entities: Disease
Species
Keywords:
implanted cardiac defibrillators; systematic review; ventricular fibrillation; ventricular tachycardia
Mesh： See more »
Year: 2017
PMID： 28687562 DOI： 10.1136/heartjnl-2016-310852
Source DB: PubMed Journal: Heart ISSN： 1355-6037 Impact factor: 5.994