Subcutaneous Defibrillators Now Recommended in the Latest (2015) ESC Guidelines
for the management of patients with ventricular arrhythmias and the prevention of SCD
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"The available data suggest that subcutaneous defibrillators are effective in preventing sudden death."
ESC guidelines and key clinical data support the safety and effi cacy of the S-ICD, demonstrating that it is a fi rst line solution for the prevention of SCD in a majority of ICD-indicated patients.
POOLED Study Implanted Patients (n = 882)2
|Age (years)||50.3 ± 16.9|
|Male||636 (72.5 %)|
|Ischemic||330 (37.8 %)|
|Genetic||58 (6.7 %)|
|Idiopathic VF||40 (4.6 %)|
|Channelopathies||90 (10.3 %)|
|NYHA Classification II-IV||327 (37.5 %)|
|Atrial Fibrillation||143 (16.4 %)|
|Previous Defibrillator||120 (13.7 %)|
|ESC Guidelines Recommendation1||Classa||Levelb|
|Subcutaneous defi brillators should be considered as an alternative to transvenous defi brillators in patients with an indication for an ICD when pacing therapy for bradycardia support, cardiac resynchronization or antitachycardia pacing is not needed.||IIa||C|
ICD = implantable cardioverter defi brillator.
a Class of recommendation.
b Level of evidence.
|Patient requiring:||At implant||Post implant|
|Pacing3||6 %||2 % / Year4|
|ATP5||1.8 % / Year||1.8 % / Year|
|Extraction for:||(985 patients)9|
|Pacing||1 % (0.1 %)|
|ATP||5 % (0.5 %)|
S-ICD should be considered for patients at risk of SCD unless…6,7
Patient prioritisation (as per McLeod et al, 2015)
* <65 (10 – 15 years life expectancy) as defi ned by ESC guidelines for management of atrial fi brillation, 2011
** The S-ICD System is indicated for patients who do not have symptomatic bradycardia, incessant ventricular tachycardia, or spontaneous, frequently recurring ventricular tachycardia that is reliably terminated with antitachycardia pacing.