NEW: Prof Matteo Bertini’s comment on this edition of the ClinicalEVIDENCE newsletter:
Matteo Bertini, M.D, PhD, FAIAC
Professor of Cardiology, Head of EP lab, Cardiological Center, Sant’ Anna University Hospital
“Quality of life with ICD is key. Sub-analyses of ATLAS and PRAETORIAN found no significant QoL differences between TV-ICD and S-ICD, helping align device choice with patient values and lifestyle.
Long-term outcomes differ: PRAETORIAN-XL (8 years) showed lower overall complications with S-ICD (11.6% vs 8.0%, p=0.15, trend only). When focusing on major complications, S-ICD was significantly lower (10.2% vs 5.7%, p=0.03), mainly from fewer lead-related issues (8.3% vs 2.4%, p<0.001).
The takeaway? S-ICD should be considered for all patients, especially young, without pacing indications whenever feasible.
Learn more in the newsletter.”
Summary
This edition of Clinical Evidence presents new findings on S-ICD, confirming its safety during physical activity and strong patient acceptance across clinical profiles. Data from the ATLAS and PRAETORIAN trials, along with long-term results from PRAETORIAN XL, support the use of S-ICD in patients without pacing indications by showing lower rates of lead-related and major complications compared to transvenous ICDs.
Additionally, recent evidence reinforces the value of HeartLogic™ in identifying patients at higher risk of heart failure readmissions and supporting efficient care delivery.
Key Takeaways
- Physical activity and S-ICD safety: Real-world data from 602 young patients show that an active lifestyle does not increase the risk of arrhythmias or inappropriate shocks¹.
- Patient experience and quality of life with S-ICD: ATLAS² and PRAETORIAN³ trial sub-analyses confirm comparable quality of life and device acceptance between S-ICD and TV-ICD recipients.
- Long-term safety outcomes from PRAETORIAN XL: Over 8 years of follow-up, S-ICD patients experienced fewer major and lead-related complications than those with TV-ICD⁴.
- HeartLogic and readmission risk: New evidence supports HeartLogic’s role in predicting heart failure events and enabling proactive care with efficient use of clinical resources⁵,⁶.
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