Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry
<b>Background:</b> The advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) marked a significant milestone in the course of cardiac rhythm devices, particularly for patients who are deemed at high risk for ventricular arrhythmias and sudden cardiac death. This extracar...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-06-01
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| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/13/7/1510 |
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| Summary: | <b>Background:</b> The advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) marked a significant milestone in the course of cardiac rhythm devices, particularly for patients who are deemed at high risk for ventricular arrhythmias and sudden cardiac death. This extracardiac approach makes the S-ICD an especially valuable option for young patients, those with difficult venous access, or those at high risk of infection. Although the S-ICD does not provide pacing for bradycardia or heart failure, it has shown efficacy in treating ventricular arrhythmias while minimizing complications associated with transvenous systems. <b>Methods</b>: The purpose of this multicenter retrospective analysis was to assess the real-world efficacy and safety of the S-ICD in a heterogeneous population. <b>Results</b>: The GASP registry consisted of 114 patients, 68% male, aged 41 ± 15 years, with a mean LVEF of 50%. In the follow-up of 35 months, inappropriate shocks occurred in 7% while appropriate shocks occurred in 6.2%. The most common reasons for inappropriate shocks were myopotentials and atrial tachyarrhythmias. Thirty-day complication-free rates were 97.3%, with the majority of patients requiring device extraction due to infection. Over the longer term, four patients required re-intervention due to local discomfort, while one device was extracted for infection. In a multivariate analysis, complications were not significantly higher in the sicker population, such as those with diabetes, kidney disease requiring dialysis, or heart failure. <b>Conclusions</b>: These findings support the growing role of the S-ICD as an alternative to the TV-ICD, especially in patients without pacing indications. |
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| ISSN: | 2227-9059 |