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 A. Friedman, Yong Mei Cha

Research output: Contribution to journalArticlepeer-review

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% (χ2=1.854, P=0.368) and 9.3% vs. 3.5% (χ2=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%, χ2=1.055, P=0.496). The S-ICD group had higher T-wave oversensing than T-ICD group (9.3% vs. 0%, χ2=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

Keywords

  • Hypertrophic cardiomyopathy
  • Implantable cardioverter-defibrillator
  • Outcome
  • Subcutaneous implantable cardioverter-defibrillator

ASJC Scopus subject areas

  • Medicine(all)

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