Infection and mortality after implantation of a subcutaneous ICD after transvenous ICD extraction
Key result
S-ICD after TV-ICD extraction is linked to low major reinfection and ~3% all-cause mortality.
- n=866
Why the study?
Information on safety outcomes after subcutaneous ICD implantation in patients undergoing transvenous ICD explantation is limited.
Does S-ICD implantation after TV-ICD extraction for infection increase the risk of subsequent reinfection compared to de novo S-ICD implantation?
Comparison
S-ICD implantation after TV-ICD extraction vs de novo S-ICD implantation
Design
Cohort study from S-ICD IDE Study and EFFORTLESS Registry
Follow-up
Mean 651 days
Authors
Discussion
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Member takes
Implication
Low reinfection rates may support S-ICD after extraction; leaves open randomized comparison to de novo implantation.
Study Design
Type
Cohort (n=866)
Structured PICO
Does S-ICD implantation after TV-ICD extraction for infection increase the risk of subsequent reinfection compared to de novo S-ICD implantation?
P
Population
866 patients receiving an S-ICD, including 119 with prior TV-ICD explantation and 747 de novo implants, followed for a mean of 651 days.
E
Exposure
Subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation after transvenous ICD (TV-ICD) extraction
C
Comparator
De novo S-ICD implantation (no prior ICD)
O
Outcome
All-cause mortality and major infection after S-ICD implantationsafety
S-ICD implantation is a safe alternative for patients requiring device replacement after TV-ICD extraction, with a low risk of reinfection even in those explanted for prior system-related infection.
Cite This Study
Boersma et al. (2015) conducted a cohort in Prior TV-ICD explantation or de novo ICD indication (n=866). S-ICD implantation after TV-ICD extraction vs. De novo S-ICD implantation was evaluated on All-cause mortality and major infection. Subcutaneous ICD implantation after transvenous ICD extraction was associated with low rates of major reinfection and an overall all-cause mortality of 3.2% over a mean follow-up of 651 days.