HRS: Subcutaneous Defibrillators Are Effective

Subcutaneous implantable cardioverter offers viable alternative to standard defibrillator

THURSDAY, May 5 (HealthDay News) -- A new minimally invasive subcutaneous implantable cardioverter defibrillator (S-ICD) system is an acceptable alternative to conventional implantable cardiac defibrillators (ICDs), according to a study presented at the Heart Rhythm Society's Annual Scientific Sessions, held from May 4 to 7 in San Francisco.

Lara Dabiri Abkenari, M.D., from the Erasmus Medical Center in the Netherlands, and colleagues described the initial clinical experience with a new S-ICD system. S-ICDs were implanted without fluoroscopy, according to guidelines, in 98 patients with cardiac disease such as ischemic cardiomyopathy (40 patients), non-ischemic dilated cardiomyopathy, Brugada syndrome, and idiopathic ventricular fibrillation (VF). A primary prevention indication was present in 62 patients. Defibrillation efficacy was tested after implantation using 65 J shocks. Patients were followed up for an average of nine months.

The investigators found that the S-ICD system accurately detected and successfully converted all episodes of induced VF through appropriate shock. The S-ICD system accurately detected 34 spontaneous ventricular arrhythmias (sustained and non-sustained) in six patients, and effectively treated 23 arrhythmic episodes in three patients. Eight patients experienced inappropriate therapy due to oversensing but a software upgrade prevented recurrence of inappropriate therapy.

"All episodes of VF were accurately detected, and successfully converted. No sudden death occurred. In our experience, the S-ICD system is a viable alternative to conventional ICD systems for selected patients," the authors write.

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