Comparison of Single-Coil Versus Dual-Coil Implantable Cardioverter Defibrillator Devices: A Systematic Review and Meta-Analysis of Efficacy and Extraction-Related Outcomes.

BACKGROUND

Implantable cardioverter defibrillators (ICD) are battery-operated devices used to manage irregular heart rhythms and deliver therapeutic shocks to the heart. This updated systematic review and meta-analysis compares the efficacy and extraction-related outcomes of single-coil versus dual-coil ICDs in view of conflicting data.

METHODS

Several databases, including PubMed, Cochrane Library, and Google Scholar, were comprehensively explored dating from inception to April 1, 2024. Data were compared using odds ratio (OR), hazard ratio (HR), and mean differences (MD). A value of p < 0.05 indicated statistical significance.

RESULTS

Ultimately, 28 studies were included in this quantitative synthesis. Defibrillation threshold (DFT) indicated statistical superiority in the dual-coil cohort (MD: 0.58; 95% confidence interval [CI]: 0.07-1.09; p = 0.03). In addition, all-cause mortality was significantly elevated in the dual-coil cohort (HR: 0.91; 95% CI: 0.87-0.97; p = 0.001). Furthermore, implant time was significantly lower in the single-coil group (MD: -7.44; 95% CI: -13.44 to -1.43; p = 0.02). Other outcomes, including first shock efficacy, cardiac mortality, post-extraction major complications, post-extraction procedural success, and post-extraction mortality, did not demonstrate any significant statistical differences.

CONCLUSION

In conclusion, despite the desirable safety profile of single-coil ICDs, the use of dual-coil ICDs continues to hold merit due to their superior efficacy and advanced sensing capabilities, especially in complex cases. In addition, the perceived risk of a greater adverse profile in dual-coil lead extraction can be refuted by preliminary aggregate results generated within this meta-analysis. However, further robust studies are warranted before arriving at a valid conclusion.