Why the study?
To discuss clinical trials and the advantages and disadvantages of the novel S-ICD technology to help physicians identify its role and select appropriate candidate patients.
What are the advantages, disadvantages, and clinical role of the subcutaneous implantable cardioverter-defibrillator (S-ICD)?
What are the advantages, disadvantages, and clinical role of the subcutaneous implantable cardioverter-defibrillator (S-ICD)?
The S-ICD is an effective alternative to transvenous ICDs that avoids lead-related complications but is limited by its inability to provide pacing.
Suitable for patients without pacing indication or high lead risk; leaves open role where antitachycardia or bradycardia pacing may be needed.
The recently commercially available subcutaneous implantable cardioverter-defibrillator (S-ICD) uses a completely subcutaneous electrode configuration to treat potentially lethal ventricular tachyarrhythmia. Clinical trials have proven its effectiveness in detecting and treating ventricular fibrillation and tachycardia. The S-ICD offers the advantage of eliminating the need for intravenous and intracardiac leads and their associated risks and shortcomings. However, its major disadvantage is its inability to provide bradycardia rate support and antitachycardia pacing to terminate ventricular tachycardia. This paper discusses the S-ICD clinical trials and advantages and disadvantages of this novel technology to help the physician identify its role and select candidate patients who will benefit from this device.
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Aziz et al. (2014) studied this question.
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