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Clinical Research in Cardiology

, Volume 108, Issue 1, pp 16–21 | Cite as

Follow-up of the first patients with a totally subcutaneous ICD in Germany from implantation till battery depletion

  • Markus Bettin
  • Benjamin Rath
  • Christian Ellermann
  • Patrick Leitz
  • Florian Reinke
  • Julia Köbe
  • Lars Eckardt
  • Gerrit FrommeyerEmail author
Original Paper
  • 217 Downloads

Abstract

Background

The subcutaneous ICD is a promising treatment option in patients at risk for sudden cardiac death. Approved in 2009, the first S-ICD® in Germany was implanted in June 2010. Although large prospective registry studies have shown safety and efficacy of the system, there is a lack of long-term data with regard to battery longevity of the S-ICD®. Therefore, we report follow-up of our first initial S-ICD® cases from implantation till battery depletion.

Materials and methods

All S-ICD® patients with device replacement for battery depletion in our large single-center S-ICD® registry were included in this study. Baseline characteristics, appropriate and inappropriate shocks, and complications were documented in a median follow-up of 75.9 ± 6.8 months.

Results

Twenty-eight patients with S-ICD® systems were included in this study. Of these patients, 21 were male and 7 were female, with an overall mean age of 41.9 ± 12.6 years. Primary prevention of sudden cardiac death was the indication in 19 patients (67.9%). Ventricular tachycardia was adequately terminated in two patients (7.1%). In 7 patients, non-sustained ventricular arrhythmias were not treated. A total of three inappropriate shocks occurred in three patients (10.7%). Mean time from implantation till battery depletion was 65.8 ± 8.1 months. Only one patient presented premature elective replacement criteria because of rapid battery depletion. No lead-related complication occurred during follow-up and no complications were seen regarding device replacement. In one patient (3.6%), the system was explanted without replacement due to patient’s preference.

Conclusion

The estimated battery longevity of S-ICD® of about 5 years was reached in all but one patient. Compared to larger S-ICD® registry studies, frequency of inappropriate shocks was relatively high in the initial S-ICD® cases. Both technological improvement as well as programming and operators’ experience have led to a reduction of complications. Replacement of the S-ICD® seems to be a safe and effective procedure.

Keywords

Subcutaneous ICD Longevity Battery depletion Device replacement 

Abbreviations

ATP

Antitachycardia pacing

ERI

Elective replacement indicator

ICD

Implantable cardioverter defibrillator

SCD

Sudden cardiac death

S-ICD®

Subcutaneous implantable cardioverter defibrillator

SVT

Supraventricular tachycardia

T-ICD

Transvenous implantable cardioverter defibrillator

VF

Ventricular fibrillation

VT

Ventricular tachycardia

Notes

Compliance with ethical standards

Conflict of interest

FR, JK, LE, and GF received travel grants and lecture honoraria from Boston Scientific within the last 12 months.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cardiology II-ElectrophysiologyUniversity Hospital MünsterMunsterGermany

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