Safety and Efficacy of Subcutaneous Cardioverter Defibrillator in Patients at High Risk of Sudden Cardiac Death　― Primary Japanese Experience ―

Sasaki Shingo, Tomita Hirofumi, Tsurugi Takuo, Ishida Yuji, Shoji Yoshihiro, Nishizaki Kimitaka, Kinjo Takahiko, Endo Tomohide, Nishizaki Fumie, Hanada Kenji, Sasaki Kenichi, Horiuchi Daisuke, Kimura Masaomi, Higuma Takumi, Okamatsu Hideharu, Tanaka Yasuaki, Koyama Junjiroh, Okumura Ken

doi:10.1253/circj.cj-17-1001

Background:The entirely subcutaneous implantable cardioverter defibrillator (S-ICD) was introduced as a new alternative to conventional transvenous ICD (TV-ICD) in Japan in February 2016, but its safety and efficacy are unclear.Methods and Results:A total of 60 patients (48 men, median age, 60 years; IQR, 44–67 years; primary prevention, n=24) underwent S-ICD implantation between February 2016 and August 2017. The device pocket was formed in the intermuscular space between the serratus anterior muscle and the latissimus dorsi muscle, and the parasternal S-ICD lead was placed according to pre-implant screening. Defibrillation test was performed in 56 patients (93%). Ventricular fibrillation (VF) was induced in 55 patients and terminated by a single 65-J shock in all patients. The median time to shock therapy was 13.4 s (IQR, 12.1–14.9 s) and the median post-shock impedance of the S-ICD lead was 64 Ω (IQR, 58–77 Ω). There were no operation-related complications or subsequent infectious complications. During follow-up (median, 275 days; IQR, 107–421 days), 1 patient (1.7%) had appropriate shock for VF with successful termination, whereas 5 patients (8.3%) had inappropriate shock due to oversensing of myopotential (n=3) or T-wave (n=1), and detection of supraventricular tachycardia (n=1).Conclusions:S-ICD is a safe and effective alternative to conventional TV-ICD. The long-term safety and efficacy of the S-ICD need further investigation.

Safety and Efficacy of Subcutaneous Cardioverter Defibrillator in Patients at High Risk of Sudden Cardiac Death　― Primary Japanese Experience ―

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Safety and Efficacy of Subcutaneous Cardioverter Defibrillator in Patients at High Risk of Sudden Cardiac Death ― Primary Japanese Experience ―

この論文をさがす

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Safety and Efficacy of Subcutaneous Cardioverter Defibrillator in Patients at High Risk of Sudden Cardiac Death　― Primary Japanese Experience ―

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