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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

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Implantable cardioverter-defibrillator in patients with inherited arrhythmia syndromes: A systematic review

Paulo Medeiros1, Maria Santos2, Carina Arantes1

  • 1Department of Cardiology, Braga Hospital, Rua das comunidades Lusíadas 133, Braga 4710-243, Portugal.

Heart & Lung : the Journal of Critical Care
|March 2, 2023
PubMed

Insights

Implantable cardioverter-defibrillator (ICD) therapy for inherited arrhythmia syndromes has a 20% rate of inappropriate therapies and 22% complication rate. Individualized decisions are crucial, considering patient risk and potential ICD complications.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Implantable cardioverter-defibrillator (ICD) therapy is recognized for its benefit in inherited arrhythmia syndromes.
  • However, ICD implantation carries risks, including inappropriate therapies and device-related complications.

Approach:

  • A systematic review analyzed 36 studies with 2750 patients diagnosed with inherited arrhythmia syndromes.
  • Data on appropriate and inappropriate ICD therapies and complications were extracted from PubMed and Embase.
  • Follow-up averaged 69 months, assessing outcomes in Brugada Syndrome, CPVT, ERS, LQTS, and SQTS.

Key Points:

  • Appropriate ICD therapies occurred in 21% of patients, while inappropriate therapies affected 20%.
  • Overall ICD-related complications were observed in 22% of patients, with lead malfunction (46%) and infections (13%) being most common.
  • Recent publications indicate a trend toward lower rates of inappropriate therapies.

Conclusions:

  • ICD-related complications are significant, particularly in younger individuals with longer exposure times.
  • Subcutaneous ICD (S-ICD) presents a viable alternative to transvenous ICD for preventing sudden cardiac death.
  • Individualized patient assessment, considering risk and complication potential, is essential for optimal ICD implantation decisions.
Abstract

Keywords:
Appropriate therapyComplicationsImplantable cardioverter-defibrillatorInappropriate therapyInherited arrhythmia syndrome

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