Polish single-centre follow-up of subcutaneous implantable cardioverter-defibrillator (S-ICD) systems implanted for the prevention of sudden cardiac death

Abstract

Background and aim: Subcutaneous implantable cardioverter-defibrillator (S-ICD) is an effective and modern tool used to protect patients at risk of sudden cardiac death (SCD) from potentially life-threatening ventricular arrhythmias. The first S-ICD systems were implanted in Poland in 2014, but since that time the national experience with that therapy has been limited. Our analysis summarises the single-centre experience at the Department of Cardiology and Electrotherapy of the Medical University of Gdansk with the use of S-ICD from the year 2014 to 2017. Methods and results: The S-ICD therapy was used in 12 patients (five male, seven female, mean age 57.2 ± 12.5 years), in eight of them for the secondary prevention of SCD. No surgical complications of implantation procedures were observed during the perioperative hospitalisation nor during follow-up. During the mean follow-up of 14 ± 13 months we observed the appropriate function of the systems and a ventricular fibrillation episode successfully terminated by the device in one patient, two cases of S-ICD sensing problems (one of which led to inadequate intervention of the device), and an episode of atrial fibrillation also leading to inadequate intervention in another patient. Conclusions: S-ICD, being an effective and safe method used to treat patients at risk of SCD, may be safely and successfully introduced into clinical practice in centres new to that field. The number of complications during the initial experience and introduction of that method may be kept low if the operating team is experienced enough in cardiac electrotherapy.