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Clinical Trial
. 2019 Mar 20;132(6):631-637.
doi: 10.1097/CM9.0000000000000133.

Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators

Jin-Jun Liang  1   2 , Hideo Okamura  2 , Roshini Asirvatham  2 , Andrew Schneider  3 , David O Hodge  4 , Mei Yang  2 , Xu-Ping Li  2 , Ming-Yan Dai  2 , Ying Tian  2 , Pei Zhang  2 , Bryan C Cannon  3 , Cong-Xin Huang  1 , Paul A Friedman  2 , Yong-Mei Cha  2
Affiliations
Clinical Trial

Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators

Jin-Jun Liang et al. Chin Med J (Engl). .

Abstract

Background: The comparative outcomes of subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICD (T-ICD) have not been well studied. The aim of this study was to evaluate the safety and efficacy of currently available S-ICD and T-ICD.

Methods: The study included 86 patients who received an S-ICD and 1:1 matched to those who received single-chamber T-ICD by gender, age, diagnosis, left ventricular ejection fraction (LVEF), and implant year. The clinical outcomes and implant complications were compared between the two groups.

Results: The mean age of the 172 patients was 45 years, and 129 (75%) were male. The most common cardiac condition was hypertrophic cardiomyopathy (HCM, 37.8%). The mean LVEF was 50%. At a mean follow-up of 23 months, the appropriate and inappropriate ICD therapy rate were 1.2% vs. 4.7% (χ = 1.854, P = 0.368) and 9.3% vs. 3.5% (χ = 2.428, P = 0.211) in S-ICD and T-ICD groups respectively. There were no significant differences in device-related major and minor complications between the two groups (7.0% vs. 3.5%, χ = 1.055, P = 0.496). The S-ICD group had higher T-wave oversensing than T-ICD group (9.3% vs. 0%, χ = 8.390, P = 0.007). Sixty-five patients had HCM (32 in S-ICD and 33 in T-ICD). The incidence of major complications was not significantly different between the two groups.

Conclusions: The efficacy of an S-ICD is comparable to that of T-ICD, especially in a dominantly HCM patient population. The S-ICD is associated with fewer major complications demanding reoperation.

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Figures

Figure 1
Figure 1
Kaplan-Meier comparison of appropriate (A) and inappropriate (B) shock therapies among subcutaneous (S-ICD) and transvenous (T-ICD) implantable cardioverter-defibrillator (ICD) groups.
See this image and copyright information in PMC

References

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