The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to reduce complications associated with transvenous leads while preserving efficacy in terminating malignant ventricular arrhythmias. However, current evidence supporting the S-ICD is primarily derived from industry-sponsored studies and highly specialized centers. This study aims to offer a comprehensive, nationwide, real-world assessment of all patients who underwent S-ICD implantation in France. The HONEST (coHOrte fraNcaise des dEfibrillateurs Sous cuTanés) cohort is a French nationwide, single-arm, observational ongoing study that enrolled all patients who underwent implantation of an S-ICD (EMBLEM, Boston Scientific) between October 2012 (the first implantation in France) and December 2019. Clinical endpoints are centrally adjudicated. Overall, 4,924 (77% males; 49.9 years) patients, representing 98.2% of all S-ICD implantations during the study period in France, were included. The HONEST study represents the first nationwide cohort evaluating S-ICD recipients to provide contemporary, real-world data. Its goal is to identify areas for improvement and refine strategies to prevent sudden cardiac death. (S-ICD French Cohort Study HONEST; NCT05302115)
Garcia et al. (Sun,) studied this question.