Multicentre experience with the second-generation subcutaneous implantable cardioverter defibrillator and the intermuscular two-incision implantation technique

Autor: Pietro De Franceschi, Sabino Iliceto, Emanuele Bertaglia, Tommaso Fabris, M. Fantinel, Martino Crosato, Benedetta Ortis, Francesco Zanon, Domenico Corrado, Giulia Mattesi, Manuel De Lazzari, Elisabetta Daleffe, Vittorio Calzolari, Elena Marras, Domenico Facchin, Giuseppe Allocca, Massimo Zecchin, Mariachiara Siciliano, Federico Migliore, Lina Marcantoni
Rok vydání: 2018
Předmět:
Male
Time Factors
implantable cardioverter defibrillator
two‐incision technique
medicine.medical_treatment
Action Potentials
030204 cardiovascular system & hematology
Ventricular tachycardia
intermuscular technique
0302 clinical medicine
Heart Rate
Risk Factors
Secondary Prevention
030212 general & internal medicine
Prospective cohort study
subcutaneous implantable cardioverter defibrillator
Secondary prevention
Middle Aged
Implantable cardioverter-defibrillator
Defibrillators
Implantable
Prosthesis Failure
Treatment Outcome
two-incision technique
Italy
Population study
Female
Original Article
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
Adolescent
Defibrillation
Large population
Electric Countershock
Risk Assessment
Prosthesis Implantation
03 medical and health sciences
Young Adult
Clinical
Heart Conduction System
Physiology (medical)
medicine
Humans
Device Removal
Aged
Retrospective Studies
business.industry
Arrhythmias
Cardiac
Original Articles
medicine.disease
Surgery
Antitachycardia Pacing
business
Zdroj: Journal of Cardiovascular Electrophysiology
ISSN: 1540-8167
Popis: Introduction The recently developed second‐generation subcutaneous implantable cardioverter defibrillator (S‐ICD) and the intermuscular two‐incision implantation technique demonstrate potential favorable features that reduce inappropriate shocks and complications. However, data concerning large patient populations are lacking. The aim of this multicentre prospective study was to evaluate the safety and outcome of second‐generation S‐ICD using the intermuscular two‐incision technique in a large population study. Methods and Results The study population included 101 consecutive patients (75% male; mean age, 45 ± 13 years) who received second‐generation S‐ICD (EMBLEM; Boston Scientific, Marlborough, MA) implantation using the intermuscular two‐incision technique as an alternative to the standard implantation technique. Twenty nine (29%) patients were implanted for secondary prevention. Twenty four (24%) patients had a previously implanted transvenous ICD. All patients were implanted without any procedure‐related complications. Defibrillation testing was performed in 80 (79%) patients, and ventricular tachycardia was successfully converted at less than or equal to 65 J in 98.75% (79/80) of patients without pulse generator adjustments. During a median follow‐up of 21 ± 10 months, no complications requiring surgical revision or local or systemic device‐related infections were observed. Ten patients (9.9%) received appropriate and successful shocks for ventricular arrhythmias. Three (2.9%) patients experienced inappropriate shocks due to oversensing the cardiac signal (n = 1), noncardiac signal (n = 1), and a combination of both cardiac and noncardiac signals (n = 1), with one patient requiring device explantation. No patients required device explantation due to antitachycardia pacing indications. Conclusions According to our multicentre study, second‐generation S‐ICD implanted with the intermuscular two‐incision technique is an available safe combination and appears to be associated with a low risk of complications, such as inappropriate shocks.
Databáze: OpenAIRE
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