Ehsan Mahmoodi, Xiang Wen Lee, Blake M Freeman, Meghan A Webster, John R Betts, Haris M Haqqani, Russell A Denman
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引用次数: 0
Abstract
Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) has become an established alternative to overcome conventional transvenous ICD (TV-ICD) lead-related complications.
Aims: To describe the long-term outcomes of S-ICD implantation at a single Australian institution.
Methods: We retrospectively reviewed the clinical outcomes of consecutive patients who underwent S-ICD implantation from 2015 to 2019.
Results: In total, 128 patients (median age 52.5 years, 70% male) underwent S-ICD implantation. The indication was primary prevention in 86 patients (66%), and 22 patients (17%) had a previous transvenous device. Seventy-seven patients (60%) had heart failure, and the median left ventricular ejection fraction was 36% (29%-60%). The procedure was performed under general anaesthesia in 124 patients (97%), and the median procedure time was 105 min (interquartile range (IQR) 90-120). During a median follow-up of 4.7 years (IQR 3.8-5.8), 15 patients (12%) died, none of which were due to sudden death or device-related complications. Inappropriate shocks occurred in 17 patients (13.3%), predominantly due to T-wave oversensing (4.7%) and supraventricular arrhythmias (4.7%), and 15 patients (11.7%) received appropriate shocks. During the follow-up period, the S-ICD system was revised to TV-ICD in 10 patients (8%), and 24 patients (19%) required S-ICD generator change. Four patients (3%) underwent surgical intervention due to lead (two) or pocket-related (two) complications, and two patients (1.5%) developed pocket infection without systemic sepsis.
Conclusion: In this single-centre study, S-ICDs were implanted safely with acceptable device performance and clinical outcomes over long-term follow-up.
期刊介绍:
The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.