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Outcomes of two versus three incision techniques: Results from the subcutaneous ICD post-approval study.
- Source :
-
Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2021 Mar; Vol. 32 (3), pp. 792-801. Date of Electronic Publication: 2021 Feb 01. - Publication Year :
- 2021
-
Abstract
- Background: Traditionally, implantation of the subcutaneous implantable cardioverter defibrillator (S-ICD) requires incisions near the lateral chest wall, the xyphoid, and the superior sternal region (three-incision technique [3IT]). A two-incision technique (2IT) avoids the superior incision and has been shown to be a viable alternative in small studies with limited follow-up.<br />Objectives: To report on the long-term safety and efficacy of the 2IT compared to the 3IT procedure in a large patient cohort.<br />Methods: Patients enrolled in the S-ICD post approval study (PAS) were stratified by procedural technique (2IT vs. 3IT). Baseline demographics, comorbidities and procedural outcomes were collected. Complications and S-ICD effectiveness in treating ventricular arrhythmias through an average 3-year follow-up period were compared.<br />Results: Of 1637 patients enrolled in the S-ICD PAS, 854 pts (52.2%) were implanted using the 2IT and 782 were implanted using the 3IT (47.8%). The 2IT became more prevalent over time, increasing from 40% to 69% of implants (Q1-Q4). Mean procedure time was shorter with 2IT (69.0 vs. 86.3 min, p < .0001). No other differences in outcomes were observed between the two groups, including rates of infection, electrode migration, inappropriate shocks and first shock efficacy for treating ventricular arrhythmias.<br />Conclusion: In this large cohort of patients implanted with an S-ICD and followed for 3 years the 2IT was as safe and effective as the 3IT while significantly reducing procedure time.<br /> (© 2021 Wiley Periodicals LLC.)
Details
- Language :
- English
- ISSN :
- 1540-8167
- Volume :
- 32
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 33492734
- Full Text :
- https://doi.org/10.1111/jce.14914