Prevention of Sudden Cardiac Death: Focus on the Subcutaneous Implantable Cardioverter-Defibrillator

The implantable cardioverter-defibrillator (ICD) is the most effective therapy to prevent sudden cardiac death (SCD) in high-risk patients. To overcome infections and failure of transvenous leads, the most frightening complications of conventional ICDs, a completely subcutaneous ICD (S-ICD) has been...

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Bibliographic Details
Published in:High blood pressure & cardiovascular prevention 2020-08, Vol.27 (4), p.291-297
Main Authors: Adduci, Carmen, Palano, Francesca, Silvetti, Giacomo, Cosentino, Pietro, Francia, Pietro
Format: Article
Language:English
Subjects:
Algorithms
Automation
Cardiac arrhythmia
Cardiology
Cardiomyopathy
Cardiovascular disease
Disease prevention
Ejection fraction
Electrodes
Failure
Heart rate
Infections
Ischemia
Medicine
Medicine & Public Health
Patients
Pharmacotherapy
Review Article
Transplants & implants
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Summary:The implantable cardioverter-defibrillator (ICD) is the most effective therapy to prevent sudden cardiac death (SCD) in high-risk patients. To overcome infections and failure of transvenous leads, the most frightening complications of conventional ICDs, a completely subcutaneous ICD (S-ICD) has been developed and is currently adopted in routine clinical practice. In view of their long life-expectancy, low competitive risk of dying from non-arrhythmic causes, and high lifetime risk of lead-related complications requiring surgical revisions, young patients with cardiomyopathies and inherited arrhythmia syndromes have traditionally been considered ideal candidates for the S-ICD. However, as growing evidence supported S-ICD safety and efficacy, initial niche implant indications were abandoned in favor of a widespread use of this technology, that is currently adopted in common ICD candidates with severe left ventricular dysfunction. Indeed, guidelines recommend S-ICD implantation as an alternative to TV-ICDs in all ICD candidates, unless pacing is required. This review focuses on the contemporary experience with the S-ICD and explores future scenarios in which device-to-device communication will enable to combine leadless therapies.
ISSN:1120-9879
1179-1985
DOI:10.1007/s40292-020-00394-x