Frommeyer Gerrit, Dechering Dirk G, Kochhäuser Simon, Bettin Markus, Köbe Julia, Eckardt Lars, Reinke Florian
Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
J Interv Card Electrophysiol. 2016 Nov;47(2):185-188. doi: 10.1007/s10840-016-0143-4. Epub 2016 May 23.
The totally subcutaneous implantable defibrillator (S-ICD) has been designed as a new alternative to conventional implantable defibrillators. This system is especially attractive for young patients. However, long-term experience is not yet available. To address the question whether the S-ICD system is safe and feasible for young patients with electrical heart disease or idiopathic ventricular fibrillation (VF), the data of a standard of care prospective single center S-ICD registry were evaluated.
In the present study, 24 patients (age 34.2 ± 11.5 years) with electrical heart disease or idiopathic VF received an S-ICD for primary (n = 8) or secondary prevention (n = 16). The mean follow-up duration was 29.6 ± 15.1 months.
Ventricular arrhythmias were adequately detected in four patients (17 %). In three patients (13 %) oversensing was noticed and led to at least one inappropriate shock in two patients (8 %). Further adverse events included surgical revision due to a mobile pulse generator as well as explantation of one system and switch to a transvenous ICD system due to several ineffective shocks.
The results of the present study suggest that S-ICD therapy may be an attractive alternative in young patients with electrical heart disease or idiopathic VF. However, episodes of oversensing as well as ineffective shocks may occur.
完全皮下植入式除颤器（S-ICD）已被设计为传统植入式除颤器的一种新替代方案。该系统对年轻患者尤其具有吸引力。然而，目前尚无长期经验。为探讨S-ICD系统对于患有电心脏病或特发性室颤（VF）的年轻患者是否安全可行，对一项标准治疗前瞻性单中心S-ICD注册研究的数据进行了评估。
在本研究中，24例患有电心脏病或特发性VF的患者（年龄34.2±11.5岁）接受了S-ICD植入，用于一级预防（n = 8）或二级预防（n = 16）。平均随访时间为29.6±15.1个月。
4例患者（17%）的室性心律失常得到了充分检测。3例患者（13%）出现感知过度，导致2例患者（8%）至少发生1次不适当电击。其他不良事件包括因脉冲发生器移动而进行手术修复，以及1例系统被取出并因多次无效电击而转换为经静脉ICD系统。
本研究结果表明，S-ICD治疗对于患有电心脏病或特发性VF的年轻患者可能是一种有吸引力的替代方案。然而，可能会发生感知过度和无效电击的情况。
