Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland.
Cardiol J. 2023;30(2):214-220. doi: 10.5603/CJ.a2022.0073. Epub 2022 Aug 17.
A subcutaneous implantable cardioverter-defibrillator (S-ICD) has become a recognized alternative to a traditional transvenous implantable cardioverter-defibrillator (T-ICD). Despite the growing evidence of non-inferiority of S-ICD, there are no clear clinical guidelines for selection of either of the two available systems. The aim of the study was to analyze the decisions made in predefined typical clinical scenarios by Polish cardiologists experienced in the use of both S-ICDs and T-ICDs.
A group of 30 experts of cardiac electrotherapy experienced in the use of S-ICDs was recruited and invited to participate in a web-based anonymous survey. The survey questions regarded the proposed therapy in various but typical clinical scenarios.
From the invited 30 experts representing 18 clinical centers, 25 completed the survey. 72% of them declared that the number of S-ICDs implanted at their center during the preceding 12 months exceeded 10, and 40% - that it was over 20. Rates of responders preferring S-ICD or T-ICD in various clinical scenarios are reported and discussed in detail.
Significant divergence of opinion exists among Polish experts regarding the use of a subcutaneous cardioverter-defibrillator. It is especially pronounced on the issue of the use of the system in middle-age patients, in case of complications of the hitherto ICD therapy, or the need of upgrading the existing cardiac implantable electronic device.
皮下植入式心律转复除颤器（S-ICD）已成为传统经静脉植入式心律转复除颤器（T-ICD）的一种公认替代方案。尽管 S-ICD 的非劣效性证据不断增加，但对于两种可用系统中的任何一种，都没有明确的临床指南来选择。本研究旨在分析经验丰富的 S-ICD 和 T-ICD 的波兰心脏病专家在预设的典型临床情况下做出的决策。
招募了一组 30 名经验丰富的心脏电疗专家，并邀请他们参加基于网络的匿名调查。调查问题涉及各种典型临床情况下的拟议治疗方案。
在受邀的 30 名代表 18 个临床中心的专家中，有 25 名完成了调查。其中 72%的人表示，他们所在中心在过去 12 个月中植入的 S-ICD 数量超过 10 个，40%的人表示超过 20 个。报告并详细讨论了在各种临床情况下，专家更倾向于选择 S-ICD 或 T-ICD 的比例。
波兰专家在使用皮下心律转复除颤器方面存在明显的意见分歧。在中年患者使用该系统、先前 ICD 治疗出现并发症或需要升级现有心脏植入电子设备等问题上，分歧尤为明显。
