Comparison of Single-Coil Versus Dual-Coil Implantable Cardioverter Defibrillator Devices: A Systematic Review and Meta-Analysis of Efficacy and Extraction-Related Outcomes

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-02-05 DOI:10.1002/clc.70083

Muhammad Fawad Tahir, Adeena Maryyum, Zainab Mubbashir, Abdul Moiz Khan, Syed Irtiza Imam, Fatima Mustafa, Syeda Zahra Hasan, Umer Shoaib, Areej Iqbal, Osama Saeed, Manisha Purushotham, Maimoona Khan, Shahtaj Tariq, Muhammad Omar Larik, Muhammad Umair Anjum, Muhammad Hasanain, Tanesh Ayyalu, Mah I. Kan Changez, Javed Iqbal

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Abstract

Background

Implantable cardioverter defibrillators (ICD) are battery-operated devices used to manage irregular heart rhythms and deliver therapeutic shocks to the heart. This updated systematic review and meta-analysis compares the efficacy and extraction-related outcomes of single-coil versus dual-coil ICDs in view of conflicting data.

Methods

Several databases, including PubMed, Cochrane Library, and Google Scholar, were comprehensively explored dating from inception to April 1, 2024. Data were compared using odds ratio (OR), hazard ratio (HR), and mean differences (MD). A value of p < 0.05 indicated statistical significance.

Results

Ultimately, 28 studies were included in this quantitative synthesis. Defibrillation threshold (DFT) indicated statistical superiority in the dual-coil cohort (MD: 0.58; 95% confidence interval [CI]: 0.07–1.09; p = 0.03). In addition, all-cause mortality was significantly elevated in the dual-coil cohort (HR: 0.91; 95% CI: 0.87–0.97; p = 0.001). Furthermore, implant time was significantly lower in the single-coil group (MD: −7.44; 95% CI: −13.44 to −1.43; p = 0.02). Other outcomes, including first shock efficacy, cardiac mortality, post-extraction major complications, post-extraction procedural success, and post-extraction mortality, did not demonstrate any significant statistical differences.

Conclusion

In conclusion, despite the desirable safety profile of single-coil ICDs, the use of dual-coil ICDs continues to hold merit due to their superior efficacy and advanced sensing capabilities, especially in complex cases. In addition, the perceived risk of a greater adverse profile in dual-coil lead extraction can be refuted by preliminary aggregate results generated within this meta-analysis. However, further robust studies are warranted before arriving at a valid conclusion.

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单圈与双圈植入式心律转复除颤器装置的比较：疗效和提取相关结果的系统回顾和荟萃分析

植入式心律转复除颤器（ICD）是一种电池供电的设备，用于控制不规则的心律，并向心脏提供治疗性电击。这篇更新的系统综述和荟萃分析比较了单线圈与双线圈icd的疗效和提取相关的结果，考虑到相互矛盾的数据。方法对PubMed、Cochrane Library、谷歌Scholar等数据库进行综合检索，检索时间为数据库成立至2024年4月1日。采用优势比（OR）、风险比（HR）和平均差异（MD）对数据进行比较。p <； 0.05表示有统计学意义。结果最终纳入了28项研究。除颤阈值（DFT）在双线圈组中具有统计学优势(MD: 0.58；95%置信区间[CI]: 0.07-1.09；p = 0.03)。此外，双线圈组的全因死亡率显著升高(HR: 0.91；95% ci: 0.87-0.97；p = 0.001)。此外，单线圈组种植时间明显较短(MD:−7.44；95% CI:−13.44 ~−1.43；p = 0.02)。其他结果，包括首次休克疗效、心脏死亡率、拔牙后主要并发症、拔牙后手术成功率和拔牙后死亡率，没有显示出任何显著的统计学差异。总之，尽管单线圈icd具有良好的安全性，但由于其优越的疗效和先进的传感能力，特别是在复杂病例中，使用双线圈icd仍然具有优势。此外，本荟萃分析中产生的初步汇总结果可以驳斥双线圈引线拔管中更大不良影响的感知风险。然而，在得出有效的结论之前，还需要进一步的有力研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.