S-ICD Implantation Following TV-ICD: Insights Into Patients With Infections and Abandoned Leads-the HONEST Cohort.

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2025-04-24 DOI:10.1016/j.jacep.2025.04.020

Vasileios Sousonis, Peggy Jacon, Fawzi Kerkouri, Rodrigue Garcia, Christelle Marquié, Walid Amara, Fréderic Anselme, Nicolas Badenco, Nathalie Behar, Mohamed Belhameche, Abdeslam Bouzeman, Samir Fareh, Benoît Guy-Moyat, Alexis Hermida, Jérome Hourdain, Laurence Jesel, Pierre Khattar, Ziad Khoueiry, Gabriel Laurent, Vladimir Manenti, Alexis Mechulan, Aymeric Menet, Antoine Milhem, Pierre Mondoly, Pierre Ollitrault, David Perrot, Michael Peyrol, Bertrand Pierre, Nicolas Sadoul, Didier Scarlatti, Jerome Taieb, Claire Vanesson, Pierre Winum, Vincent Probst, Eloi Marijon, Pascal Defaye, Serge Boveda

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引用次数: 0

Abstract

Background: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) can be a viable option for patients with transvenous ICDs experiencing complications (rescue S-ICD).

Objectives: This study sought to evaluate the outcomes of rescue S-ICD implantation using data from the HONEST French nationwide S-ICD cohort.

Methods: All rescue S-ICD patients were identified. Outcomes (complications, reinterventions, and mortality) were compared between rescue and de novo S-ICD patients. Subgroup analyses were performed based on the implantation indication (infective vs noninfective) and the presence of abandoned leads.

Results: Among 4,924 patients in the HONEST cohort, 651 underwent rescue S-ICD implantation (295 with infective indications, 244 with abandoned leads). Over a follow-up of 4.2 ± 2.2 years, complications and reinterventions were similar in rescue and de novo S-ICD patients (22.6% vs 21.0%; P = 0.35 and 8.7% vs 7.2%; P = 0.17, respectively), in infective and noninfective rescue S-ICD patients (21.6% vs 23.5%; P = 0.55 and 8.9% vs 8.6%; P = 0.90, respectively) and in patients with abandoned and extracted leads (24.3% vs 21.7%; P = 0.46 and 8.3% vs 9.0%; P = 0.77, respectively). Mortality was higher in rescue compared to de novo S-ICD patients (16.9% vs 10.2%; P < 0.001) and in rescue S-ICD patients with infective indications (29.2% vs 6.7%; P < 0.001) and extracted leads (21.9% vs 8.6%; P < 0.001), mainly due to a higher burden of comorbidities, as none of these parameters was independently associated with mortality in multivariate analyses. No S-ICD-related deaths were observed.

Conclusions: Rescue S-ICD implantation is an acceptable option for patients with device-related complications. Lead abandonment in the setting of a noninfective indication appears to be safe. (S-ICD French Cohort Study [HONEST]; NCT05302115).

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S-ICD植入后的电视- icd：洞察患者感染和放弃铅-诚实队列。

背景：皮下植入式心律转复除颤器（S-ICDs）是经静脉icd患者出现并发症（抢救S-ICD）的可行选择。目的：本研究试图利用法国HONEST全国S-ICD队列的数据来评估抢救性S-ICD植入的结果。方法：对所有抢救的S-ICD患者进行鉴定。结果（并发症、再干预和死亡率）在抢救和新生S-ICD患者之间进行比较。根据植入适应症（感染vs非感染）和废弃导联的存在进行亚组分析。结果：在4924例HONEST队列中，651例患者接受了抢救性S-ICD植入（295例有感染指征，244例有废弃导联）。在4.2±2.2年的随访中，抢救和新生S-ICD患者的并发症和再干预相似(22.6% vs 21.0%；P = 0.35和8.7% vs 7.2%；P = 0.17)，在感染和非感染抢救S-ICD患者中(21.6% vs 23.5%；P = 0.55和8.9% vs 8.6%；P = 0.90)，以及丢弃导联和拔出导联的患者(24.3% vs 21.7%；P = 0.46和8.3% vs 9.0%；P = 0.77)。抢救死亡率高于新生S-ICD患者(16.9% vs 10.2%；P < 0.001)和有感染指征的抢救S-ICD患者(29.2% vs 6.7%；P < 0.001)和提取导联(21.9% vs 8.6%；P < 0.001)，主要是由于较高的合并症负担，因为在多变量分析中，这些参数都与死亡率无关。未观察到s - icd相关死亡。结论：抢救性S-ICD植入术是有器械相关并发症的患者可接受的选择。在无感染指征的情况下弃铅似乎是安全的。S-ICD法国队列研究[HONEST]；NCT05302115)。

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

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.