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

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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.

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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

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Authors and Affiliations

  1. Department of Cardiology II-Electrophysiology, University Hospital Münster, Munster, Germany

    Markus Bettin, Benjamin Rath, Christian Ellermann, Patrick Leitz, Florian Reinke, Julia Köbe, Lars Eckardt & Gerrit Frommeyer

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  1. Markus Bettin
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  2. Benjamin Rath
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  3. Christian Ellermann
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  4. Patrick Leitz
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  5. Florian Reinke
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  6. Julia Köbe
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  7. Lars Eckardt
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  8. Gerrit Frommeyer
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Corresponding author

Correspondence to Gerrit Frommeyer.

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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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Bettin, M., Rath, B., Ellermann, C. et al. Follow-up of the first patients with a totally subcutaneous ICD in Germany from implantation till battery depletion. Clin Res Cardiol 108, 16–21 (2019). https://doi.org/10.1007/s00392-018-1296-1

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  • DOI: https://doi.org/10.1007/s00392-018-1296-1

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