Why the study?
The S-ICD has a higher average defibrillation threshold than the T-ICD, requiring a larger device capable of generating an 80-J shock and generally requiring defibrillation efficacy testing.
Do modifications to the subcutaneous implantable-cardioverter defibrillator coil reduce the defibrillation threshold?
Do modifications to the subcutaneous implantable-cardioverter defibrillator coil reduce the defibrillation threshold?
The text discusses the rationale for modifying the S-ICD coil to reduce its higher defibrillation threshold compared to transvenous ICDs.
Coil modifications may lower S-ICD thresholds; prospective trials needed before clinical adoption.
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is approved as an alternative to the traditional transvenous implantable cardioverter-defibrillator (T-ICD). The S-ICD has a higher average defibrillation threshold (DFT) than the T-ICD, related primarily to greater distance from shocking coil to ventricular myocardium of the S-ICD. Therefore, the S-ICD utilizes a larger device capable of generating an 80-J shock compared to maximal shock output of 35–40 J typical for T-ICDs, and defibrillation efficacy testing is generally recommended for the S-ICD.
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Heist et al. (2023) studied this question.
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