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The subcutaneous ICD for prevention of sudden cardiac death: Current evidence and future directions


Steffel, Jan (2020). The subcutaneous ICD for prevention of sudden cardiac death: Current evidence and future directions. Pacing and Clinical Electrophysiology : PACE, 43(12):1421-1427.

Abstract

Despite major advances in medical therapy, sudden cardiac death remains an important cause of cardiovascular mortality. In order to improve the risk-benefit balance of transvenous implantable cardioverter-defibrillator (ICD) systems, a totally subcutaneous ICD (S-ICD) system was developed and approved for use in Europe in 2009. The currently available S-ICD system has undergone several important hardware- and software-related modifications and improvements over the last 10 years aimed at further improving its efficacy and safety. The results of the PRAETORIAN trial, that is, the first randomized comparison of S-ICD versus transvenous ICDs, of the prospective UNTOUCHED study, and the overall consistent observational data underline that current generation S-ICD systems may be a valid alternative in patients with an ICD indication in whom bradycardia pacing or cardiac resynchronization therapy is not required due to a lower risk of system-related problems. This review summarizes the key differences between the two systems, improvements in hardware components and algorithms over time, as well as most recent clinical evidence regarding the efficacy and safety of the S-ICD.

Abstract

Despite major advances in medical therapy, sudden cardiac death remains an important cause of cardiovascular mortality. In order to improve the risk-benefit balance of transvenous implantable cardioverter-defibrillator (ICD) systems, a totally subcutaneous ICD (S-ICD) system was developed and approved for use in Europe in 2009. The currently available S-ICD system has undergone several important hardware- and software-related modifications and improvements over the last 10 years aimed at further improving its efficacy and safety. The results of the PRAETORIAN trial, that is, the first randomized comparison of S-ICD versus transvenous ICDs, of the prospective UNTOUCHED study, and the overall consistent observational data underline that current generation S-ICD systems may be a valid alternative in patients with an ICD indication in whom bradycardia pacing or cardiac resynchronization therapy is not required due to a lower risk of system-related problems. This review summarizes the key differences between the two systems, improvements in hardware components and algorithms over time, as well as most recent clinical evidence regarding the efficacy and safety of the S-ICD.

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Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Cardiology and Cardiovascular Medicine
Language:English
Date:December 2020
Deposited On:01 Feb 2021 16:57
Last Modified:02 Feb 2021 21:01
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0147-8389
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/pace.14066
PubMed ID:32896919

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