Shock Efficacy of Subcutaneous Implantable Cardioverter-Defibrillator for Prevention of Sudden Cardiac Death

• DOI: 10.1161/circep.112.973339
• Publication Date: 2012-08-24T04:21:15Z
• Authors: Ali Aydin; Friederike Hartel; Michael Schlüter; Christian Butter; Julia Köbe; Martin Seifert; Nils Gosau; Boris Hoffmann; Matthias Hoffmann; Eik Vettorazzi; Iris Wilke; Karl Wegscheider; Hermann Reichensp...; Lars Eckardt; Daniel Steven; Stephan Willems
• Keywords: Interquartile range; Defibrillation threshold

Background— Recently, subcutaneous implantable cardioverter-defibrillator (S-ICD) has become available. The aim of our study was to assess the efficacy S-ICD in a clinical setting. Methods and Results— Between June 2010 July 2011, 40 consecutive patients (42±15 years; body mass index, 27±6 kg/m 2 ; left ventricular ejection fraction, 47±15%; 28 men) received an for primary (n=17) or secondary prevention (n=23 [58%]) at 3 institutions Germany. Intraoperative defibrillation testing failed 1 patient with severely reduced fraction; effective all other patients. All episodes stored were analyzed appropriate inappropriate detection, as well shock delivery convert tachyarrhythmia into sinus rhythm. During median follow-up 229 (interquartile range, 116–305) days, 4 experienced 21 episodes, correct detection subsequent therapy. A total shocks delivered these Mixed logistic regression modeling revealed 96.4% (95% CI, 12.8%–100%). first shocks, however, only 57.9% 35.6%–77.4%). Four incorrectly classified tachyarrhythmia, which led Conclusions— Ineffective may occur S-ICD, even after successful intraoperative testing. Multicenter trials are required close monitoring safety end points identify who be risk failure.