Long-time "real-life" performance of the subcutaneous ICD in patients with electrical heart disease or idiopathic ventricular fibrillation.

BACKGROUNDS: The totally subcutaneous implantable defibrillator (S-ICD) has been designed as a new alternative to conventional implantable defibrillators. This system is especially attractive for young patients. However, long-term experience is not yet available. To address the question whether the S-ICD system is safe and feasible for young patients with electrical heart disease or idiopathic ventricular fibrillation (VF), the data of a standard of care prospective single center S-ICD registry were evaluated.

METHODS: In the present study, 24 patients (age 34.2 ± 11.5 years) with electrical heart disease or idiopathic VF received an S-ICD for primary (n = 8) or secondary prevention (n = 16). The mean follow-up duration was 29.6 ± 15.1 months.

RESULTS: Ventricular arrhythmias were adequately detected in four patients (17 %). In three patients (13 %) oversensing was noticed and led to at least one inappropriate shock in two patients (8 %). Further adverse events included surgical revision due to a mobile pulse generator as well as explantation of one system and switch to a transvenous ICD system due to several ineffective shocks.

CONCLUSIONS: The results of the present study suggest that S-ICD therapy may be an attractive alternative in young patients with electrical heart disease or idiopathic VF. However, episodes of oversensing as well as ineffective shocks may occur.