Pooled analysis of complications with transvenous ICD compared to subcutaneous ICD in patients with catecholaminergic polymorphic ventricular arrhythmia
Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is associated with arrhythmic events which may lead to sudden cardiac death (SCD). A leading therapy for CPVT besides medical treatment with beta-blockers is the use of an implantable cardioverter-defibrillator (ICD). For this...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
28 March 2022
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| In: |
Journal of Personalized Medicine
Year: 2022, Volume: 12, Issue: 4, Pages: 1-9 |
| ISSN: | 2075-4426 |
| DOI: | 10.3390/jpm12040536 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jpm12040536 Verlag, kostenfrei, Volltext: https://www.mdpi.com/2075-4426/12/4/536 
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| Author Notes: | Henrik Eckert, Ibrahim El-Battrawy, Michael Veith, Gretje Roterberg, Jacqueline Kowitz, Siegfried Lang, Xiaobo Zhou, Ibrahim Akin, Andreas Mügge and Assem Aweimer |
| Summary: | Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is associated with arrhythmic events which may lead to sudden cardiac death (SCD). A leading therapy for CPVT besides medical treatment with beta-blockers is the use of an implantable cardioverter-defibrillator (ICD). For this paper we compared data from a pooled analysis to get further evidence about the complications of transvenous and subcutaneous ICDs. Methods: We gathered data from a search of PubMed, Web of Science, Cochrane Library and Cinahl. For our analysis, we chose 30 studies with a total number of 784 patients. We compared the data regarding complications caused by different ICD device types. Results: During a mean follow up of 38.9 months for the patients with ICD implantation (n = 337), data showed a complication rate of 101 (30%). A total of 330 (98%) of them received a transvenous-ICD (T-ICD) and 7 (2%) a subcutaneous-ICD (S-ICD). A total of 97 (29.4%) of the T-ICD patients and 4 (57.1%) of the S-ICD patients had at least one complication. Of the 234 complications that occurred in T-ICD patients 152 (65%) were inappropriate shocks due to supraventricular arrhythmias, T/R-wave oversensing or electrode defect, 26 (11.1%) lead fracture/failure, 1 (0.4%) electrode defect, 46 were (19.7%) events of electrical storms, 1 (0.4%) thromboembolic event, 2 (0.8%) cases of endocarditis and 6 (2.6%) infections of the ICD-pocket. Ten (100%) of the complications for the four patients with the S-ICD were an event of an inappropriate shock due to supraventricular arrhythmias, T/R-wave oversensing or electrode defect. Conclusion: Subcutaneous ICDs (S-ICD) show a certain advantage over T-ICDs regarding lead-related complications. Nevertheless, they still show problems with inappropriate shocks and other ICD related complications. Therefore, a case-by-case decision is advised, but the continuous improvement of S-ICD might make it an overall advantageous therapy option in the future. |
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| Item Description: | Gesehen am 18.03.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2075-4426 |
| DOI: | 10.3390/jpm12040536 |