2017 AHA HRS ACC Guidelines Recommendations
|I||B-NR||1. In patients who meet criteria for an ICD who have inadequate vascular access or are at high risk for infection, and in whom pacing for bradycardia or VT termination or as part of CRT is neither needed nor anticipated, a subcutaneous implantable cardioverter-defibrillator is recommened (1-5).|
|II||B-NR||2. In patients who meet indication for an ICD, implantation of a subcutaneous implantable cardioverter-defibrillator is reasonable if pacing for bradycardia or VT termination or as part of CRT is neither needed nor anticipated (1-4).|
|III: Harm||B-NR||3. In patients with an indication for bradycardia pacing or CRT, or for whom antitachycardia pacing for VT termination is required, a subcutaneaus implantable cardioverter-defibrillator should not be implanted (1-4, 6-8).|
“The risk of infection appears to be lower with subcutaneous implantable cardioverter-defibrillators than with transvenous ICDs (1-4).Therefore, a subcutaneous implantable cardioverter-defibrillator may be preferred in patients who are at high risk of infection, such as those with a prior device infection, ESRD, diabetes mellitus, or who are chronically immunosuppressed.”*
* Al-Khatib, SM, Stevenson, WG, Ackerman, MJ, et al., 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. Heart Rhythm, 2017.
|Patient requiring:||At implant||Post implant|
|Pacing1||6 %||2 % / Year2|
|ATP3||1.8 % / Year||1.8 % / Year|
|Extraction for:||(985 patients)4|
|Pacing||1 % (0.1 %)|
|ATP||5 % (0.5 %)|
The S-ICD has been implanted in a Broad Range of Patients
S-ICD System Patient Population from the IDE Study5
The S-ICD System is an effective option for a majority of ICD candidates, both with primary and secondary indications.
** 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.