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Subcutaneous Implantable Cardiac Defibrillators: Indications and Limitations

  • Management of Heart Failure (TE Meyer, Section Editor)
  • Published:
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Abstract

The implantable cardioverter defibrillator is today an indisputable evidence-based treatment for cardiac sudden death both in primary and secondary prevention. However, trans-venous cardioverter defibrillator implantation still carries a not negligible risk of complications both acutely and during follow-up. Trans-venous endocardial lead is the weak link of implantable cardioverter defibrillator (ICD) technology being the source of most mechanical complications on vessels and heart structures and exposed to infection, malfunction and recalls. A totally subcutaneous defibrillation lead has recently been introduced in clinical practice. With the subcutaneous pulse generator forms a defibrillation system that leaves the vessels and the heart completely “untouched.” Subcutaneous ICD has proven to be safe and effective in many clinical trials. Patients without pacing indications and at higher risk of complications from trans-venous lead implantation represent the perfect candidates to S-ICD technology. However, with technical improvement, it is reasonable to expect a further expansion of indications.

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Conflict of Interest

Maria Grazia Bongiorni, Stefano Viani, Giulio Zucchelli, Andrea Di Cori, Luca Segreti, Luca Paperini, Dianora Levorato, Adriano Boem, Giulia Branchitta, Diana Andreini and Ezio Soldati declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Cardiothoracic and Vascular Department, New Santa-Chiara Hospital, Pisa, Italy

    Maria Grazia Bongiorni, Stefano Viani, Giulio Zucchelli, Andrea Di Cori, Luca Segreti, Luca Paperini, Dianora Levorato, Adriano Boem, Giulia Branchitta, Diana Andreini & Ezio Soldati

Authors
  1. Maria Grazia Bongiorni
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  2. Stefano Viani
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  3. Giulio Zucchelli
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  4. Andrea Di Cori
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  5. Luca Segreti
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  6. Luca Paperini
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  7. Dianora Levorato
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  8. Adriano Boem
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  9. Giulia Branchitta
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  10. Diana Andreini
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  11. Ezio Soldati
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Correspondence to Stefano Viani.

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This article is part of the Topical Collection on Management of Heart Failure

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Bongiorni, M.G., Viani, S., Zucchelli, G. et al. Subcutaneous Implantable Cardiac Defibrillators: Indications and Limitations. Curr Heart Fail Rep 12, 79–86 (2015). https://doi.org/10.1007/s11897-014-0242-4

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  • DOI: https://doi.org/10.1007/s11897-014-0242-4

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