Erik Oosterwerff, Ahmet Adiyaman, Arif Elvan, Abdul Ghani, Lennaert Hoek, Karel Breeman, Jaap Jan Smit, Anand Ramdat Misier, Peter Paul Delnoy
{"title":"与非缺血性患者相比,缺血性患者的不适当电击明显减少:高容量单中心S-ICD经验。","authors":"Erik Oosterwerff, Ahmet Adiyaman, Arif Elvan, Abdul Ghani, Lennaert Hoek, Karel Breeman, Jaap Jan Smit, Anand Ramdat Misier, Peter Paul Delnoy","doi":"10.1111/pace.14364","DOIUrl":null,"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":1.3000,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/pace.14364","citationCount":"1","resultStr":"{\"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, Ahmet Adiyaman, Arif Elvan, Abdul Ghani, Lennaert Hoek, Karel Breeman, Jaap Jan Smit, Anand Ramdat Misier, Peter Paul Delnoy\",\"doi\":\"10.1111/pace.14364\",\"DOIUrl\":null,\"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\":1.3000,\"publicationDate\":\"2021-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1111/pace.14364\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pacing and clinical electrophysiology : PACE\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/pace.14364\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/9/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pacing and clinical electrophysiology : PACE","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.14364","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/9/24 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Significantly less inappropriate shocks in ischemic patients compared to non-ischemic patients: The S-ICD experience of a high volume single-center.
Background: The subcutaneous cardioverter-defibrillator (S-ICD) continues to be preferentially used in relatively young patients, with less advanced heart disease.
Objective: We, therefore, studied the short and long-term efficacy and safety of the S-ICD in subgroups of patients, which are underreported at present.
Methods: 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.
Results: 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.
Conclusion: 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.