Subcutaneous ICD Reduces Lead-Related Complications

MONDAY, Nov. 7, 2022 (HealthDay News) — The subcutaneous implantable cardioverter defibrillator (S-ICD) reduces lead-related complications, according to a study published online Nov. 8 in the Annals of Internal Medicine.

Jeff S. Healey, M.D., from the Population Health Research Institute in Hamilton, Ontario, Canada, and colleagues assessed key ICD performance measures related to delivery of ICD therapy, including inappropriate ICD shocks and failed ICD shocks, in a multicenter trial involving 544 eligible patients with a primary or secondary indication for an ICD aged younger than 60 years and with cardiogenetic phenotype or prespecified risk factors for lead complications. Overall, 503 patients were randomly assigned to S-ICD or transvenous ICD (TV-ICD; 251 and 252 patients, respectively) and were followed for a mean of 2.5 years.

The researchers identified a statistically significant reduction in perioperative, lead-related complications, which occurred in 0.4 and 4.8 percent of patients with an S-ICD and TV-ICD, respectively. A trend for more inappropriate shocks was seen with S-ICD (hazard ratio, 2.37; 95 percent confidence interval, 0.98 to 5.77), but there was no increase in failed appropriate ICD shocks (hazard ratio, 0.61; 95 percent confidence interval, 0.15 to 2.57). More ICD site pain was reported by patients in the S-ICD group on the day of implant and one month later.

“The S-ICD is an alternative to a TV-ICD, particularly in patients at increased risk for lead-related complications,” the authors write.

The study was funded by Boston Scientific.

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