Author + information
- Received June 5, 2017
- Revision received August 15, 2017
- Accepted August 30, 2017
- Published online December 18, 2017.
- Markus Bettin, MD∗ (, )
- Robert Larbig, MD,
- Benjamin Rath, MD,
- Alicia Fischer, MD,
- Gerrit Frommeyer, MD,
- Florian Reinke, MD,
- Julia Köbe, MD and
- Lars Eckardt, MD
- Division of Clinical and Experimental Electrophysiology, Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany
- ↵∗Address for correspondence:
Dr. med. Markus Bettin, Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1 Gebäude A1, D-48149 Münster, Germany.
Objectives This study sought to examine the use of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in teenagers and young adults.
Background The S-ICD is an important advance in device therapy for the prevention of sudden cardiac death. Although guidelines recommend S-ICD use, long-term data are still limited, especially in subgroups. Therefore, this study analyzed teenagers and young adults <26 years of age with S-ICD in our large single-center S-ICD registry.
Methods Between July 2010 and December 2016, 147 S-ICD systems were inserted at our institution. Thirty-one patients were included in the study; 13 were teenagers (<20 years of age), and 18 were young adults (20 to 26 years of age). The patients were compared with an age-matched control group with transvenous ICDs.
Results Primary prevention of sudden cardiac death was the indication in 13 patients (41.9%). Ventricular arrhythmias were adequately terminated in 8 patients (25.8%). In 5 patients (16.1%), oversensing resulting in at least 1 inappropriate shock was observed. All inappropriate shocks occurred in teenagers. Younger age was an independent predictor of inappropriate shocks in S-ICD (hazard ratio: 0.56; 95% confidence interval: 0.34 to 0.92; p < 0.05). No ineffective shocks were observed in a median follow-up of 25.7 ± 20.2 months.
Conclusions Young patients may be suitable candidates for S-ICD because of the high number of lead failures with transvenous systems expected in these patients during their lifetime. In the present study, S-ICD therapy was safe and feasible in teenagers and young adults. However, episodes of inappropriate shocks may occur, but rates of inappropriate shocks were comparable to those in patients with transvenous ICDs.
Drs. Bettin, Reinke, Köbe, and Eckardt have received travel grants and lecture honoraria from Biotronik, Boston Scientific, Medtronic, Sorin Group, and St. Jude Medical. Drs. Reinke and Eckardt were both members of the advisory board of Cameron Health. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received June 5, 2017.
- Revision received August 15, 2017.
- Accepted August 30, 2017.
- 2017 American College of Cardiology Foundation
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