Why the study?
What are the advantages, limitations, and ideal candidate profiles for the entirely subcutaneous defibrillator (S-ICD) compared to traditional transvenous defibrillators?
What are the advantages, limitations, and ideal candidate profiles for the entirely subcutaneous defibrillator (S-ICD) compared to traditional transvenous defibrillators?
The S-ICD is a valid alternative to transvenous defibrillators, offering substantial advantages for specific patient subgroups such as young patients and those with prior device infections.
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Offers cautious support for S-ICD in targeted subgroups; leaves open need for randomized data on broader use.
The traditional transvenous defibrillator has been one of the greatest advancement in Cardiology in the last 30 years and has demonstrated to reduce arrhythmic and total mortality in selected patients. However the traditional defibrillator can have a high price to pay in terms of complications, the "weakest link" being the transvenous/endocardial leads. The entirely subcutaneous defibrillator (S-ICD) has recently entered into the clinical scenario and represents a valid alternative to the transvenous device. S-ICD can provide substantial advantages, especially among some subgroups of patients (i.e. after device infection, in young patients and arrhythmogenic syndromes). However, given its characteristics, it is fundamental to choose patients that can benefit the most. In this review we will describe advantages and limitations of the SICD and point-out how to select the "ideal candidate" for the implantation.
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Maria et al. (2014) studied this question.
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