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Comparative outcomes of subcutaneous and transvenous cardioverter-defibrillators

摘要Background:The comparative outcomes of subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICD (T-ICD) have not been well studied.The aim of this study was to evaluate the safety and efficacy of currently available S-ICD and T-ICD.Methods:The study included 86 patients who received an S-ICD and 1∶1 matched to those who received single-chamber T-ICD by gender,age,diagnosis,left ventricular ejection fraction (LVEF),and implant year.The clinical outcomes and implant complications were compared between the two groups.Results:The mean age of the 172 patients was 45 years,and 129 (75%) were male.The most common cardiac condition was hypertrophic cardiomyopathy (HCM,37.8%).The mean LVEF was 50%.At a mean follow-up of 23 months,the appropriate and inappropriate ICD therapy rate were 1.2 % vs.4.7% (x2 =1.854,P =0.368) and 9.3 % vs.3.5 % (x2 =2.428,P =0.211) in S-ICD and T-ICD groups respectively.There were no significant differences in device-related major and minor complications between the two groups (7.0% vs.3.5%,x =1.055,P=0.496).The S-ICD group had higher T-wave oversensing than T-ICD group (9.3% vs.0%,x2=8.390,P =0.007).Sixty-five patients had HCM (32 in S-ICD and 33 in T-ICD).The incidence of major complications was not significantly different between the two groups.Conclusions:The efficacy of an S-ICD is comparable to that of T-ICD,especially in a dominantly HCM patient population.The S-ICD is associated with fewer major complications demanding reoperation.

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作者单位 Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan,Hubei,430060,China;Department of Cardiovascular Medicine,Mayo Clinic,Rochester,MN 55905,USA [1] Department of Cardiovascular Medicine,Mayo Clinic,Rochester,MN 55905,USA [2] Division of Pediatric Cardiology,Mayo Clinic,Rochester,MN 55905,USA [3] Biostatistics Unit,Mayo Clinic,Jacksonville,FL 32224,USA [4] Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan,Hubei,430060,China [5]
栏目名称 Original Articles
DOI 10.1097/CM9.0000000000000133
发布时间 2019-04-29
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中华医学杂志(英文版)

中华医学杂志(英文版)

2019年132卷6期

631-637页

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