The subcutaneous internal cardiac defibrillator effectively cardioverts ventricular arrhythmias, achieving a 100% acute conversion rate of induced VF in evaluable patients without pacing indications.
Does the Subcutaneous Internal Cardiac Defibrillator (S-ICD) effectively cardiovert ventricular arrhythmias with acceptable safety in patients without pacing indications?
The S-ICD represents a major advance for patients needing an ICD without pacing indications, offering comparable defibrillation efficacy while negating the risks of transvenous leads.
Absolute Event Rate: 100% vs 88%
The Subcutaneous Internal Cardiac Defibrillator (S-ICD) represents a major advance in the care of patients who have an indication for an internal cardiac defibrillator without pacing indications. Its main advantage is that it can deliver a shock to cardiovert ventricular arrhythmias utilising a tunnelled subcutaneous lead, negating the risks associated with conventional transvenous systems. Initial studies have shown comparable efficacy in cardioversion of induced and spontaneous ventricular tachycardia (VT) and ventricular fibrillation (VF) when compared to conventional transvenous systems. In addition, inappropriate shocks occurred in a similar percentage of patients to conventional ICD studies. Complication rates are low and relate largely to localised wound infections, treated successfully with antibiotics. The long term efficacy of the device is yet to be ascertained, however, a randomised trial & prospective registries are currently in progress to enable direct comparison with transvenous ICDs. This article summarises the early clinical experience and trials in the implantation of the S-ICD.
Lambiase et al. (Thu,) conducted a review in Ventricular arrhythmias and risk of sudden cardiac death (n=1,110). Subcutaneous Internal Cardiac Defibrillator (S-ICD) vs. Pre-specified performance goal (transvenous ICD historical data) was evaluated on Induced ventricular fibrillation (VF) conversion rate (IDE trial). The subcutaneous internal cardiac defibrillator effectively cardioverts ventricular arrhythmias, achieving a 100% acute conversion rate of induced VF in evaluable patients without pacing indications.