Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)631-637
Number of pages7
JournalChinese medical journal
Volume132
Issue number6
DOIs
StatePublished - Mar 20 2019

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Defibrillators
Implantable Defibrillators
Stroke Volume
Hypertrophic Cardiomyopathy
Reoperation
Safety
Equipment and Supplies
Incidence

ASJC Scopus subject areas

  • Medicine(all)

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Liang, J. J., Okamura, H., Asirvatham, R., Schneider, A., Hodge, D. O., Yang, M., ... Cha, Y-M. (2019). Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators. Chinese medical journal, 132(6), 631-637. https://doi.org/10.1097/CM9.0000000000000133

Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators. / Liang, Jin Jun; Okamura, Hideo; Asirvatham, Roshini; Schneider, Andrew; Hodge, David O.; Yang, Mei; Li, Xu Ping; Dai, Ming Yan; Tian, Ying; Zhang, Pei; Cannon, Bryan C.; Huang, Cong Xin; Friedman, Paul Andrew; Cha, Yong-Mei.

In: Chinese medical journal, Vol. 132, No. 6, 20.03.2019, p. 631-637.

Research output: Contribution to journalArticle

Liang, JJ, Okamura, H, Asirvatham, R, Schneider, A, Hodge, DO, Yang, M, Li, XP, Dai, MY, Tian, Y, Zhang, P, Cannon, BC, Huang, CX, Friedman, PA & Cha, Y-M 2019, 'Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators', Chinese medical journal, vol. 132, no. 6, pp. 631-637. https://doi.org/10.1097/CM9.0000000000000133
Liang JJ, Okamura H, Asirvatham R, Schneider A, Hodge DO, Yang M et al. Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators. Chinese medical journal. 2019 Mar 20;132(6):631-637. https://doi.org/10.1097/CM9.0000000000000133
Liang, Jin Jun ; Okamura, Hideo ; Asirvatham, Roshini ; Schneider, Andrew ; Hodge, David O. ; Yang, Mei ; Li, Xu Ping ; Dai, Ming Yan ; Tian, Ying ; Zhang, Pei ; Cannon, Bryan C. ; Huang, Cong Xin ; Friedman, Paul Andrew ; Cha, Yong-Mei. / Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators. In: Chinese medical journal. 2019 ; Vol. 132, No. 6. pp. 631-637.
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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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AU - Liang, Jin Jun

AU - Okamura, Hideo

AU - Asirvatham, Roshini

AU - Schneider, Andrew

AU - Hodge, David O.

AU - Yang, Mei

AU - Li, Xu Ping

AU - Dai, Ming Yan

AU - Tian, Ying

AU - Zhang, Pei

AU - Cannon, Bryan C.

AU - Huang, Cong Xin

AU - Friedman, Paul Andrew

AU - Cha, Yong-Mei

PY - 2019/3/20

Y1 - 2019/3/20

N2 - 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.

AB - 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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