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Long-term follow-up of subcutaneous ICD systems in patients with hypertrophic cardiomyopathy: a single-center experience

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Abstract

Background

The totally subcutaneous implantable defibrillator (S-ICD) was introduced as a new alternative to conventional implantable defibrillators and is employed worldwide. This system is especially attractive for young patients. However, in patients with hypertrophic cardiomyopathy (HCM), T-wave oversensing may occur. To address the question whether the S-ICD system is suitable for HCM patients, the data of a standard of care prospective single-center S-ICD registry were evaluated.

Methods and results

In the present study, 18 HCM patients who received an S-ICD for primary (n = 14) or secondary prevention (n = 4) and a minimal follow-up duration of 6 months were analyzed. The mean follow-up duration was 31.7 ± 15.4 months. Ventricular arrhythmias were adequately detected in 4 patients (22 %). In 7 patients (39 %), T-wave oversensing was noticed and led to at least one inappropriate shock in 4 patients (22 %). Further adverse events included surgical revision due to a mobile sensing electrode and resulting noise detection as well as one case of early battery failure requiring pulse generator change.

Conclusion

Patients with HCM and S-ICD systems have an increased risk of T-wave oversensing and inappropriate shock delivery. Thorough monitoring as well as exercise tests may help to improve device settings and thereby prevent T-wave oversensing.

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Authors and Affiliations

  1. Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany

    Gerrit Frommeyer, Dirk G. Dechering, Sven Zumhagen, Julia Köbe, Lars Eckardt & Florian Reinke

  2. Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Münster, Münster, Germany

    Andreas Löher

Authors
  1. Gerrit Frommeyer
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  2. Dirk G. Dechering
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  3. Sven Zumhagen
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  4. Andreas Löher
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  5. Julia Köbe
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  6. Lars Eckardt
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  7. Florian Reinke
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Corresponding author

Correspondence to Gerrit Frommeyer.

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Conflict of interest

G.F., D.G.D., S.Z., J.K., L.E., and F.R. received travel grants and lecture honoraria from BIOTRONIK, Boston Scientific, Medtronic, Sorin Group and St. Jude Medical.

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Frommeyer, G., Dechering, D.G., Zumhagen, S. et al. Long-term follow-up of subcutaneous ICD systems in patients with hypertrophic cardiomyopathy: a single-center experience. Clin Res Cardiol 105, 89–93 (2016). https://doi.org/10.1007/s00392-015-0901-9

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  • DOI: https://doi.org/10.1007/s00392-015-0901-9

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