Pacing and clinical electrophysiology : PACE最新文献

{"title":"Comparative outcomes of Riata and Fidelis lead management strategies: Results from the NCDR-ICD Registry.","authors":"Emily P Zeitler, Yongfei Wang, Sean D Pokorney, Jeptha Curtis, Jordan M Prutkin","doi":"10.1111/pace.14361","DOIUrl":"https://doi.org/10.1111/pace.14361","url":null,"abstract":"The Medtronic Sprint Fidelis® and Abbott Riata®/Riata ST® leads are at risk of failure and are subject to FDA recall. Comparative risks of various lead management strategies during elective generator change in a multi‐center population are unknown. We aim to describe patients with functional, recalled ICD leads undergoing elective generator replacement and report outcomes according to lead management strategies.","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1897-1906"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39415249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis use disorder among atrial fibrillation admissions, 2008-2018.","authors":"Fouad Chouairi,&nbsp;P Elliott Miller,&nbsp;Avirup Guha,&nbsp;John-Ross Clarke,&nbsp;Samuel W Reinhardt,&nbsp;Tariq Ahmad,&nbsp;James V Freeman,&nbsp;Nihar R Desai,&nbsp;Daniel J Friedman","doi":"10.1111/pace.14356","DOIUrl":"https://doi.org/10.1111/pace.14356","url":null,"abstract":"<p><strong>Background: </strong>Despite changes inthe legality of cannabis use and the increasing prevalence of cannabis use disorder (CUD), there is little data investigating the association between CUD and inpatient atrial fibrillation (AF) hospitalizations.</p><p><strong>Methods: </strong>Using the National Inpatient Sample, we identified Atrial Fibrillation (AF) hospitalizations with and without a codiagnosis of CUD using International Classification of Diseases diagnosis codes and compared demographics, socioeconomics, comorbidities, outcomes, and trends between cohorts.</p><p><strong>Results: </strong>Between 2008 and 2018, we identified 5,155,789 admissions for AF of which 31,768 (0.6%) had a codiagnosis of CUD. The proportion of admissions with a history of CUD increased from 0.3% in 2008 to 1.0% in 2018 (p < .001). Hospital discharges of patients with CUD were significantly younger (53 vs. 72 years, p < .001), had a higher proportion of black race (CUD: 26.6% vs. 8.0%, p < .001), and had a higher proportion of income in the lowest income quartile than without a codiagnosis of CUD (CUD: 40.5% vs. 26.2%, p < .001).</p><p><strong>Conclusions: </strong>CUD is increasingly prevalent among AF hospitalizations, particularly among young patients. Codiagnosis of CUD in AF hospitalizations is also more common in underserved patients. As a result, it is important for future research to examine and understand the impact of CUD on this population, particularly in the light of changing legislation surrounding the legality of cannabis.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1934-1938"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39403896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Permanent His-bundle pacing using distal His-bundle electrogram-guided approach in patients with atrioventricular block.","authors":"Kazumasa Suga,&nbsp;Hiroyuki Kato,&nbsp;Yasuya Inden,&nbsp;Satoshi Yanagisawa,&nbsp;Hisashi Murakami,&nbsp;Kenji Kada,&nbsp;Naoya Tsuboi,&nbsp;Toyoaki Murohara","doi":"10.1111/pace.14363","DOIUrl":"https://doi.org/10.1111/pace.14363","url":null,"abstract":"<p><strong>Background: </strong>Permanent His-bundle pacing (HBP) is effective and safe; however, the success rate of HBP is low, especially in patients with infranodal block. This study aimed to assess the efficacy and feasibility of HBP implantation using an electrophysiological guided approach targeting a distal His-bundle electrogram (HBE) in patients with atrioventricular block (AVB).</p><p><strong>Methods: </strong>Thirty-four consecutive patients with AVB (infranodal block in 28 patients) who underwent HBP were enrolled. During implantation, we attempted to target the distal part of the HBE (distal HBE) beyond the block site based on unipolar mapping. The His-capture threshold was evaluated for 1 year after implantation.</p><p><strong>Results: </strong>HBP was achieved in 26 patients and in 21 patients (75%) with infranodal block. Detection of distal HBE was significantly higher in the successful HBP group than in the HBP failure group (65.4% vs. 0%, p = .001). Among 15 patients with intra-Hisian block, 14 patients (93%) successfully achieved HBP with distal HBE detection. During the 1-year follow-up period, an increase in His-capture threshold by ≥1.0 V at 1.0 ms occurred in five (19.2%) of 26 patients. The increased His-capture threshold group exhibited significantly less detection of distal HBE (20% vs. 76.2%; odds ratio 0.078, 95% confidence interval 0.07-0.87, p = .038) and a higher His-capture threshold at implantation (2.0 ± 1.1 V vs. 1.1 ± 0.9 V; odds ratio 1.702, 95% confidence interval 1.025-2.825, p = 0.04) than the non-increased His-capture threshold group.</p><p><strong>Conclusion: </strong>HBP implantation guided by distal HBE approach may be feasible with subsequent stable pacing in patients with intra-Hisian and atrioventricular nodal block.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1907-1917"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39414813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of patients explanted for implantable cardioverter defibrillator infections: Bridge therapy with external temporary ICD.","authors":"Gabriele Dell'Era,&nbsp;Eleonora Prenna,&nbsp;Matteo Ziacchi,&nbsp;Igor Diemberger,&nbsp;Marco Varalda,&nbsp;Federico Guerra,&nbsp;Mauro Biffi,&nbsp;Eraldo Occhetta,&nbsp;Giuseppe Patti","doi":"10.1111/pace.14355","DOIUrl":"https://doi.org/10.1111/pace.14355","url":null,"abstract":"<p><strong>Aims and methods: </strong>In case of cardiacimplantable electronicdevice (CIED)-related infections, it is mandatory to completely remove the device and administer prolonged antibiotic therapy. The management of patients explanted for an implantable defibrillator (ICD) infection is complex especially in patients needing anti-bradycardia pacing or tachyarrhythmia protection. We tested the efficacy and safety of a conventional ICD externally connected to a transvenous dual-coil lead as bridging therapy before the reimplant, comparing outcomes with a historical cohort of patients (N = 113) treated with temporary transvenous pacing. We enrolled 18 patients explanted for ICD infection and needing prolonged antibiotic therapy in three high-volume Italian centers. They received an external ICD stand-by for a mean of 16.5 (4-30) days before the reimplant.</p><p><strong>Results: </strong>No patient experienced malfunction of the system, with a significant reduction of this complication versus temporary transfemoral pacing (37%, p = .004). Post-procedural occurrence of other complications (infection, relevant local bleeding, ventricular tachycardia during insertion of the lead, cardiac perforation, and venous thromboembolism) was low and not different in the two groups. One patient experienced an electrical storm, effectively recognized by the external ICD and treated with anti-tachycardia pacings (ATPs) and shocks.</p><p><strong>Conclusions: </strong>An approach with an external ICD seems to be a safe and viable option as bridging therapy in patients requiring ICD explant for CIED infection.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1884-1889"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39415690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse device-device interaction between pacemaker and subcutaneous implantable cardiac defibrillator.","authors":"Nicholas Abbott,&nbsp;Aron Bender,&nbsp;Charles Henrikson,&nbsp;Jared Miller,&nbsp;Babak Nazer,&nbsp;Seshadri Balaji","doi":"10.1111/pace.14325","DOIUrl":"https://doi.org/10.1111/pace.14325","url":null,"abstract":"<p><p>A 26-year-old patient with prior surgery for Ebstein's anomaly and a pacemaker (placed for post-surgical heart block and poor underlying rhythm) underwent SICD was placement. During defibrillation testing, device-device interaction led to undersensing of ventricular fibrillation with failure to shock. Increasing the pacemaker sensitivity resolved the problem but post shock pacing was unable to capture the heart after both shocks. The patient underwent removal of both the pacemaker and the SICD and placement of a transvenous ICD. Complex device-device interactions can occur in patients who are pacemaker dependent and undergo placement of a SICD.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1944-1948"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39211661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New onset atrial fibrillation in the ICU: An unexplored future of anticoagulation.","authors":"Ryan Brunetti,&nbsp;Edan Zitelny,&nbsp;Prashant D Bhave","doi":"10.1111/pace.14369","DOIUrl":"https://doi.org/10.1111/pace.14369","url":null,"abstract":"In the letter to the editor, “New-onset AF in theMedical Intensive Care Unit: Catch me if you can,” Vadakken et al. raised very interesting postulations regarding duration of atrial fibrillation (AF) and associated patient outcomes. The data regarding new-onset AF in the setting of acute illness warranting admission to the medical intensive care unit is limited,1,2,3 with few validated tools for risk stratification and optimal management for these patients. One limitation of our study is an unclear total duration of AF (as well as the duration of the longest AF episode) during the admission as a consequence of our retrospective study design. The group from McMaster University presented data estimating the incidence of newonset AF lasting at least 30 s in critically ill patients at 18.9% (95% CI 14.2%−24.3%) using 14-day continuous ECGmonitors. Using continuous monitoring is a more rigorous way to surveil for episodes of newonset AF. The AF Occurring Transiently with Stress (AFOTS) follow-up study, cited by Vadakken et al.,4 will utilize serial ambulatory monitoring and therefore promises to offer valuable insight as to what happens to these types of patients after they are discharged from the hospital. As the letter by Vadakken et al. notes, the clinical team only recognized 70% of episodes of AF that were detected by the 14-day inhospital ECG patch monitor. It is well documented that AF is associated with increased risk of intracardiac thrombosis and stroke.5 This highlights the concern that we may be missing clinically significant AF and along with it, the opportunity to prevent strokes. While rigorous monitoring can help catch more episodes of new-onset AF, this raises the question of what to do with the data (e.g., what degree of AF burden is associated with ischemic stroke).6 Another related area of assessment may be to assess the relationship between CHARGE-AF and new-onset AF as compared to CHA2DS2-VASc for predictors of recurrent AF after discharge, as our study showed a closer risk prediction by the former tool as compared to the latter. Again, we are excited about the AFOTS study and eagerly await its results.4 We hope that it will shed light on factors that influence recurrent AF after discharge and help to quantify the associated stroke risk. We always welcome continued interest and insight from other research groups. Thank you for your interest in our work. Respectfully, Edan Zitelny, MD and the “New-onset atrial fibrillation incidence and associated outcomes in the medical intensive care unit” Research Team","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1953"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39469077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delta QRS distinguishes I_to -mediated J waves from pseudo J waves produced by conduction delay on body surface electrocardiographic.","authors":"Yinn Shaung Ooi,&nbsp;Mostafa Amer,&nbsp;Datun Qi,&nbsp;Zhen Yang,&nbsp;Chuanyu Gao,&nbsp;Gan-Xin Yan","doi":"10.1111/pace.14359","DOIUrl":"https://doi.org/10.1111/pace.14359","url":null,"abstract":"<p><strong>Background: </strong>On surface electrocardiographic (ECGs), it is difficult to differentiate I_to -mediated J waves, a repolarization phenomenon seen in J wave syndromes (JWS) from terminal QRS deflections that mimic J waves (pseudo J waves) in intraventricular conduction delay (IVCD), an abnormality in depolarization. We hypothesize that the difference between the \"maximum QRS duration\" inclusive of J point or terminal QRS deflections and the minimum QRS duration identified across a 12-lead ECG is significantly larger in I_to -mediated J waves, and can serve as a marker to make this distinction.</p><p><strong>Methods: </strong>A retrospective analysis was performed on adults with ECGs consisting of one of the four following manifestations: J waves associated with hypothermia and early repolarization, and pseudo J waves associated with right bundle branch block (RBBB) and non-specific intraventricular conduction delay (NS-IVCD). All ECGs were assessed individually and the maximum and minimum discrete QRS deflections on 12-lead tracings, defined as \"QRS_max \" and QRS_min , were identified. The difference between \"QRS_max \" and QRS_min , designated as ∆QRS, was calculated and compared across the studied populations.</p><p><strong>Results: </strong>A total of 60 patients consisting of 15 patients in each arm were included in the study. ΔQRS was significantly larger in the hypothermia and early repolarization groups, compared to RBBB and NS-IVCD (p < .0001), with the following mean ∆QRS: hypothermia 54.3 ± 13.7 ms, early repolarization pattern 47.3 ± 15.3 ms, RBBB 19.3 ± 6.5 ms, and NS-IVCD 16.0 ± 6.6 ms.</p><p><strong>Conclusion: </strong>∆QRS may serve as a reliable ECG parameter for distinguishing I_to -mediated J waves from pseudo J waves produced by delayed intraventricular conduction.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1832-1841"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39397709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and feasibility of implanting a transvenous implantable cardioverter defibrillator (TV-ICD) in the left axilla.","authors":"Yoshinari Enomoto,&nbsp;Mahito Noro,&nbsp;Yasutake Toyoda,&nbsp;Rina Ishii,&nbsp;Masako Asami,&nbsp;Takahito Takagi,&nbsp;Naohiko Sahara,&nbsp;Hikari Hashimoto,&nbsp;Shingo Kujime,&nbsp;Keijiro Nakamura,&nbsp;Hidehiko Hara,&nbsp;Masao Moroi,&nbsp;Kaoru Sugi,&nbsp;Masato Nakamura","doi":"10.1111/pace.14362","DOIUrl":"https://doi.org/10.1111/pace.14362","url":null,"abstract":"<p><strong>Background: </strong>Transvenous implantable cardioverter defibrillator (TV-ICD) systems are commonly implanted in the left anterior chest because of an easier implantation and better defibrillation threshold. This study aimed to evaluate the safety and feasibility of left axillary implantations of TV-ICD systems.</p><p><strong>Methods: </strong>We performed left axillary TV-ICD implantations and compared that to the major complication rate and operation time of the conventional TV-ICD implantation site (left anterior chest). The electrical parameter trends were also assessed in the left axilla group.</p><p><strong>Results: </strong>Seventy-six consecutive patients were evaluated for the analysis. Thirty-one patients had their system implanted in the left axilla and the reasons for the implantations included 29 patients for cosmetic reasons and two for post-infection conditions. The operation time and major complication rate were similar between the two groups (left anterior chest vs. left axilla: 134±62.4 min vs. 114±33.5 min, p = .11, 1/45 patient, 2.2% [pocket hematoma] vs. 1/31 patient, 3.2% [lead dislodgement], p = .77). During the follow up period (4.9±2.3years), no lead interruptions were observed in either group. The electrical lead parameters at the time of the implantation and follow up were similar in the study group (R wave sensing 20.8±33.4 vs. 11.2±7.42 mv, p = .34; lead impedance 464±64.7 vs. 418±135ohm, p = .22; pacing threshold [at 0.4 ms] 1.0±0.76 vs. 1.21±0.93V, p = .49).</p><p><strong>Conclusion: </strong>TV-ICD implantations in the left axilla were performed safely without increasing the operation time as compared to the conventional ICD implantation site. ICD implantations in the left axilla are an alternative in those not suitable for implanting TV-ICDs in the conventional implantation site.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1810-1816"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39441467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device nurse intervention facilitates the patients' adaptation to cardiac shock devices in the remote monitoring era.","authors":"Tomomi Ogawa,&nbsp;Nao Saito,&nbsp;Koji Fukuzawa,&nbsp;Kunihiko Kiuchi,&nbsp;Mitsuru Takami,&nbsp;Megumi Hayashi,&nbsp;Ryo Tanioka,&nbsp;Masaya Ota,&nbsp;Keizo Komoriya,&nbsp;Ikuko Miyawaki,&nbsp;Ken-Ichi Hirata","doi":"10.1111/pace.14348","DOIUrl":"https://doi.org/10.1111/pace.14348","url":null,"abstract":"<p><strong>Background: </strong>A substantial number of patients with shock devices (implantable cardioverter defibrillators [ICDs] or ICDs with resynchronization [CRTDs]) experience psychological distress.</p><p><strong>Objective: </strong>We investigated the device nurse telephone intervention's effect on improving the patient's adaptation to shock devices, quality of life (QOL), and anxiety in the remote monitoring era.</p><p><strong>Methods: </strong>The patient's adaptation to the device, health-related QOL, and anxiety were investigated by the modified Implanted Devices Adjustment-Japan score (IDAS), Short Form-36, and State-Trait Anxiety Inventory (STAI) before and 1-year after the device nurse telephone intervention, performed every 3 months. A total of 95 patients (median age 69 years and 25 females) participated. Sixty patients had ICDs and 35 CRTDs. Structural heart disease was observed in 72 patients, and idiopathic ventricular arrhythmias in the others. The mean left ventricular ejection fraction was 46% ± 15%. The median duration since the device implantation was 5.2 years.</p><p><strong>Results: </strong>The total IDAS score significantly improved from 28.42 ± 7.11 at baseline to 26.77 ± 7.68 (p = 0.0076) at 1 year. Both the state and trait anxiety significantly improved (from 38.9 ± 9.6 to 35.3 ± 9.0 [<0.0001] and 38.8 ± 10.3 to 36.2±9.8 [p = 0.0044], respectively). The prevalence of patients with a state and trait anxiety of more than 40 decreased from 44 (46%) and 38 (40%) patients before the study to 27 (28 %) and 32 (34 %) at 1 year. The SF-36 mental component summary score significantly increased (50.8 ± 8.3 at baseline to 53.1 ± 7.7 at 1 year, p = 0.0031).</p><p><strong>Conclusions: </strong>The device nurse intervention facilitated the patient's adaptation to the shock device, increased the health-related QOL, and reduced the patient's anxiety.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1874-1883"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39365952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significantly less inappropriate shocks in ischemic patients compared to non-ischemic patients: The S-ICD experience of a high volume single-center.","authors":"Erik Oosterwerff,&nbsp;Ahmet Adiyaman,&nbsp;Arif Elvan,&nbsp;Abdul Ghani,&nbsp;Lennaert Hoek,&nbsp;Karel Breeman,&nbsp;Jaap Jan Smit,&nbsp;Anand Ramdat Misier,&nbsp;Peter Paul Delnoy","doi":"10.1111/pace.14364","DOIUrl":"https://doi.org/10.1111/pace.14364","url":null,"abstract":"<p><strong>Background: </strong>The subcutaneous cardioverter-defibrillator (S-ICD) continues to be preferentially used in relatively young patients, with less advanced heart disease.</p><p><strong>Objective: </strong>We, therefore, studied the short and long-term efficacy and safety of the S-ICD in subgroups of patients, which are underreported at present.</p><p><strong>Methods: </strong>A total of 218 patients between November 2010 and February 2019 undergoing S-ICD with a follow up of at least 6 months implantation were included in a prospective registry. Mean follow up was 38 months.</p><p><strong>Results: </strong>The most common indication for S-ICD implantation was ischemic cardiomyopathy (n = 106, 49%). Complication rate needing invasive intervention was 9% (n = 21). Appropriate shock rate in patients with an S-ICD was 3.5%/year. A total of 30 inappropriate shocks (IAS) occurred in 19 patients (8.7%; 2.7%/year). The proportion of appropriate and inappropriate shock rates in patients with different cardiomyopathies shows remarkable variances. There were significant more IAS (3.6%/year vs. 1.7%/year, p = .048) in patients with non-ischemic cardiomyopathy versus patients with ischemic cardiomyopathy. Multivariate analysis identified, besides type of cardiomyopathy, atrial fibrillation (AF) as predictor for IAS.</p><p><strong>Conclusion: </strong>In this real-world prospective registry we analyzed S-ICD performance in the more traditional ICD patient. Patients with ischemic cardiomyopathy had significantly less inappropriate therapy compared to patients with non-ischemic cardiomyopathy and appear to be appropriate patients for this type of device.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1918-1924"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39417221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}