Article Impact Level: HIGH Data Quality: STRONG Summary of: Annals of Internal Medicine, M22-1566. https://doi.org/10.7326/M22-1566 Dr. Jeff Healey et al
Points
- The positioning of a transdermal ICD (S-ICD) was linked to a greater likelihood of ICD location pain and a tendency toward more improper ICD disruptions in contrast to the positioning of a transvenous ICD in this multicenter randomized trial of 503 service users with either a primary or secondary protection sign for an ICD.
- In this study, S-ICD insertion showed effectiveness comparable to a transvenous device. It might even be used as an alternative therapeutic approach in individuals more likely to have problems from lead exposure.
- Implantable cardioverter defibrillators increase individuals’ chances of surviving cardiopulmonary arrest. However, they are also linked to difficulties with intravenous leads. The subcutaneous Implantable Cardioverter Defibrillators, which lacks intravascular elements, were werlackated to reduce lead-related problems.
Summary
To evaluate important Implantable Cardioverter Defibrillators outcome indicators connected to the provision of ICD treatment, such as ineffective and improper ICD shocks given in the lack of a dangerous arrhythmia.
The experiment was multicenter and based on randomization. After electrocardiogram screening of 544 eligible participants, including 141 females, who were younger than 60 years, seemed to have a cardio genetic phenotype, or had predetermined potential risks for lead problems, were randomly assigned to receive a Subcutaneous Implantable Cardioverter Defibrillators. Typical follow-up lasted 2.5 years, and the average age was 49.
Perioperative significant lead-related issues were the main result. Despite the Subcutaneous Implantable Cardioverter Defibrillator’s early postoperative discomfort and propensity for more improper shocks, it dramatically reduced lead-related perioperative problems.
In the meantime, it is plausible to argue that subcutaneous implantable cardioverter defibrillators are a tried-and-true and cost-effective substitute for a Transvenous Implantable Cardioverter Defibrillator in people who do not require pacing and may even be preferable in individuals who have a high expectation of lifespan. Using the assumption that the system saves a person’s life and is typically secure and simple to implant, the collective decision regarding the exchange of shock dangers, regulatory difficulties, and the importance of proof should be conducted. Moreover, an additional explanation will notify a more accurate strategy for patient-device similarity. Outcomes from the prolonged ongoing follow-up in both PRAETORIAN and ATLAS are highly anticipated.
Despite seeming like a newcomer, the subcutaneous Implantable Cardioverter Defibrillator has been around for ten years. To assess this system’s advantages over its transvenous Implantable Cardioverter Defibrillators relative, we need prolonged head-to-head comparison facts.
Link to the article: https://www.acpjournals.org/doi/10.7326/M22-1566
References Healey, J. S., Krahn, A. D., Bashir, J., Amit, G., Philippon, F., McIntyre, W. F., Tsang, B., Joza, J., Exner, D. V., Birnie, D. H., Sadek, M., Leong, D. P., Sikkel, M., Korley, V., Sapp, J. L., Roux, J.-F., Lee, S. F., Wong, G., Djuric, A., … ATLAS Investigators*. (2022). Perioperative safety and early patient and device outcomes among subcutaneous versus transvenous implantable cardioverter defibrillator implantations: A randomized, multicenter trial. Annals of Internal Medicine, M22-1566. https://doi.org/10.7326/M22-1566
