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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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Rates of and Indications for Subcutaneous ICD Extraction: A Multihospital Healthcare System Analysis.

Arati Gangadharan1, Graham Peigh1, Mariam Arif1

  • 1Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Journal of Cardiovascular Electrophysiology
|November 11, 2024
PubMed
Summary

The subcutaneous implantable cardioverter defibrillator (S-ICD) extraction rate was 5.9% over 4.4 years, primarily due to bradycardia pacing needs, infection, or inappropriate shocks. Smoking history and higher BMI increased extraction risk.

Keywords:
ICDextractionindicationsratesubcutaneous

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • The subcutaneous implantable cardioverter defibrillator (S-ICD) offers an alternative to transvenous ICDs for patients not requiring concurrent pacing.
  • Understanding S-ICD removal rates and indications is crucial for optimizing patient care and device selection.

Purpose of the Study:

  • To investigate the rates and primary indications for S-ICD removal and extraction.
  • To identify factors associated with S-ICD extraction.

Main Methods:

  • Retrospective analysis of 372 patients who received S-ICD implantation between 2010 and 2022.
  • Evaluation of S-ICD removal/extraction as the primary endpoint.
  • Univariate and multivariate analyses to determine factors linked to S-ICD extraction.

Main Results:

  • A total of 22 patients (5.9%) underwent S-ICD extraction over a median follow-up of 4.4 years.
  • Common extraction indications included infection (22.7%), inappropriate shocks (22.7%), and need for bradycardia pacing (18.2%).
  • Smoking history and higher body mass index were independently associated with S-ICD extraction.

Conclusions:

  • The S-ICD extraction rate was 5.9%, with key indications being infection, inappropriate shocks, and bradycardia pacing needs.
  • Patient factors like smoking history and elevated BMI correlate with higher S-ICD extraction rates.
  • Careful patient selection for S-ICD implantation can minimize the need for subsequent device removal.