Markus Bettin1, Robert Larbig2, Benjamin Rath2, Alicia Fischer2, Gerrit Frommeyer2, Florian Reinke2, Julia Köbe2, Lars Eckardt2. 1. Division of Clinical and Experimental Electrophysiology, Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany. Electronic address: markus.bettin@ukmuenster.de. 2. Division of Clinical and Experimental Electrophysiology, Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany.
Abstract
OBJECTIVES: This study sought to examine the use of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in teenagers and young adults. BACKGROUND: The S-ICD is an important advance in device therapy for the prevention of sudden cardiac death. Although guidelines recommend S-ICD use, long-term data are still limited, especially in subgroups. Therefore, this study analyzed teenagers and young adults <26 years of age with S-ICD in our large single-center S-ICD registry. METHODS: Between July 2010 and December 2016, 147 S-ICD systems were inserted at our institution. Thirty-one patients were included in the study; 13 were teenagers (<20 years of age), and 18 were young adults (20 to 26 years of age). The patients were compared with an age-matched control group with transvenous ICDs. RESULTS: Primary prevention of sudden cardiac death was the indication in 13 patients (41.9%). Ventricular arrhythmias were adequately terminated in 8 patients (25.8%). In 5 patients (16.1%), oversensing resulting in at least 1 inappropriate shock was observed. All inappropriate shocks occurred in teenagers. Younger age was an independent predictor of inappropriate shocks in S-ICD (hazard ratio: 0.56; 95% confidence interval: 0.34 to 0.92; p < 0.05). No ineffective shocks were observed in a median follow-up of 25.7 ± 20.2 months. CONCLUSIONS: Young patients may be suitable candidates for S-ICD because of the high number of lead failures with transvenous systems expected in these patients during their lifetime. In the present study, S-ICD therapy was safe and feasible in teenagers and young adults. However, episodes of inappropriate shocks may occur, but rates of inappropriate shocks were comparable to those in patients with transvenous ICDs.
OBJECTIVES: This study sought to examine the use of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in teenagers and young adults. BACKGROUND: The S-ICD is an important advance in device therapy for the prevention of sudden cardiac death. Although guidelines recommend S-ICD use, long-term data are still limited, especially in subgroups. Therefore, this study analyzed teenagers and young adults <26 years of age with S-ICD in our large single-center S-ICD registry. METHODS: Between July 2010 and December 2016, 147 S-ICD systems were inserted at our institution. Thirty-one patients were included in the study; 13 were teenagers (<20 years of age), and 18 were young adults (20 to 26 years of age). The patients were compared with an age-matched control group with transvenous ICDs. RESULTS: Primary prevention of sudden cardiac death was the indication in 13 patients (41.9%). Ventricular arrhythmias were adequately terminated in 8 patients (25.8%). In 5 patients (16.1%), oversensing resulting in at least 1 inappropriate shock was observed. All inappropriate shocks occurred in teenagers. Younger age was an independent predictor of inappropriate shocks in S-ICD (hazard ratio: 0.56; 95% confidence interval: 0.34 to 0.92; p < 0.05). No ineffective shocks were observed in a median follow-up of 25.7 ± 20.2 months. CONCLUSIONS: Young patients may be suitable candidates for S-ICD because of the high number of lead failures with transvenous systems expected in these patients during their lifetime. In the present study, S-ICD therapy was safe and feasible in teenagers and young adults. However, episodes of inappropriate shocks may occur, but rates of inappropriate shocks were comparable to those in patients with transvenous ICDs.
Authors: Piotr Wieniawski; Michał Buczyński; Marcin Grabowski; Joachim Winter; Bożena Werner Journal: Int J Environ Res Public Health Date: 2022-09-16 Impact factor: 4.614
Authors: Krzysztof Kaczmarek; Maciej Kempa; Marcin Grabowski; Mateusz Tajstra; Adam Sokal; Iwona Cygankiewicz; Radosław Zwoliński; Marcin Michalak; Michal Kowara; Szymon Budrejko; Anna Kurek; Jerzy K Wranicz; Grzegorz Raczak; Grzegorz Opolski; Mariusz Gąsior; Oskar Kowalski; Paweł Ptaszyński Journal: Arch Med Sci Date: 2019-05-21 Impact factor: 3.318