Key result
The subcutaneous implantable cardioverter defibrillator demonstrated a 97.3% 30-day complication-free rate and delivered appropriate shocks in 6.2% of patients over a 35-month follow-up.
Why the study?
The study was conducted to evaluate the real-world efficacy and safety of the subcutaneous implantable cardioverter defibrillator (S-ICD) in a heterogeneous population.
Does the subcutaneous implantable cardioverter defibrillator (S-ICD) provide safe and effective therapy in a heterogeneous real-world population at high risk for ventricular arrhythmias?
Observational (n=114)
Yes
Does the subcutaneous implantable cardioverter defibrillator (S-ICD) provide safe and effective therapy in a heterogeneous real-world population at high risk for ventricular arrhythmias?
The S-ICD demonstrates favorable real-world efficacy and safety over 35 months, with low complication rates even in sicker patient populations.
Answers are grounded in this paper and cite their sources.
Supports S-ICD safety in high-risk real-world cohorts; hypothesis-generating and should not yet change practice.
Background: The advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) marked a significant milestone in the course of cardiac rhythm devices, particularly for patients who are deemed at high risk for ventricular arrhythmias and sudden cardiac death. This extracardiac approach makes the S-ICD an especially valuable option for young patients, those with difficult venous access, or those at high risk of infection. Although the S-ICD does not provide pacing for bradycardia or heart failure, it has shown efficacy in treating ventricular arrhythmias while minimizing complications associated with transvenous systems. Methods: The purpose of this multicenter retrospective analysis was to assess the real-world efficacy and safety of the S-ICD in a heterogeneous population. Results: The GASP registry consisted of 114 patients, 68% male, aged 41 ± 15 years, with a mean LVEF of 50%. In the follow-up of 35 months, inappropriate shocks occurred in 7% while appropriate shocks occurred in 6.2%. The most common reasons for inappropriate shocks were myopotentials and atrial tachyarrhythmias. Thirty-day complication-free rates were 97.3%, with the majority of patients requiring device extraction due to infection. Over the longer term, four patients required re-intervention due to local discomfort, while one device was extracted for infection. In a multivariate analysis, complications were not significantly higher in the sicker population, such as those with diabetes, kidney disease requiring dialysis, or heart failure. Conclusions: These findings support the growing role of the S-ICD as an alternative to the TV-ICD, especially in patients without pacing indications.
No takes yet. Share an insight, caveat, or question.
Milaras et al. (2025) conducted an observational in High risk for ventricular arrhythmias and sudden cardiac death (n=114). Subcutaneous implantable cardioverter defibrillator (S-ICD) was evaluated on 30-day complication-free rate. The subcutaneous implantable cardioverter defibrillator demonstrated a 97.3% 30-day complication-free rate and delivered appropriate shocks in 6.2% of patients over a 35-month follow-up.
Synapse has enriched 10 related papers. Consider them for comparative context: