Be-All End-All Real-World Evidence on the Subcutaneous ICD.

Only 4 patients needed their S-ICD replaced with a transvenous ICD because of the need for antitachycardia or cardiac resynchronization therapy pacing, but none needed device replacement for bradycardia pacing. 1 Published in August 2020, the PRAETORIAN trial (Prospective, Randomized Comparison of Subcutaneoous and Transvenous Implantable Cardioverter Defibrillator Therapy) was the first trial to compare the S-ICD with the transvenous ICD in patients with ICD indications and no pacing requirements. Only 12 patients (1.1%) had their S-ICD explanted because of an infection, and no patient had bacteremia. This trial was a prospective, multinational investigation of patients with an indication for a primary prevention ICD on the basis of a reduced ejection fraction that aimed to evaluate the rate of inappropriate ICD shocks in a real-world contemporary ICD patient population receiving generation 2 or 3 S-ICD with optimal device programming and improved discrimination algorithms. [Extracted from the article]