Why the study?
Traditional TV-ICDs cause mechanical and infectious complications, while S-ICDs circumvent some of these risks but have inherent limitations such as inappropriate shocks, lack of pacing capabilities, and shorter longevity.
Does the subcutaneous ICD prevent sudden cardiac death with fewer complications compared to transvenous ICDs in patients without pacing indications?
Does the subcutaneous ICD prevent sudden cardiac death with fewer complications compared to transvenous ICDs in patients without pacing indications?
S-ICDs serve as a viable, guideline-supported alternative to traditional transvenous ICDs for sudden cardiac death prevention in patients who do not require pacing.
The ICD is an important therapy in the prevention of sudden cardiac death. The transvenous-ICD (TV-ICD) has been the primary device used for this purpose. However, mechanical and infectious complications occur with traditional TV-ICDs increasing morbidity and mortality. The subcutaneous-ICD (S-ICD) system was developed to circumvent some of these complications, but S-ICDs have their inherent set of limitations as well. These include inappropriate shock delivery, lack of bradycardia, antitachycardia or CRT pacing therapy and shorter device longevity. The S-ICD is now included in guidelines as an acceptable alternative to TV-ICDs among patients without pacing indications. This review discusses the rationale for S-ICDs by reviewing studies including the PRAETORIAN, PAS, and UNTOUCHED trials.
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John et al. (2021) studied this question.
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