title: Suitability for subcutaneous defibrillator implantation: results based on data from routine clinical practice.
abstract: OBJECTIVE
  To assess the proportion of current implantable cardioverter defibrillator (ICD) recipients who would be suitable for a subcutaneous lead ICD (S-ICD).
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Tertiary care facility in the Netherlands.
  
  
  METHODS
  All patients who received a single- or dual-chamber ICD in the Leiden University Medical Center between 2002 and 2011. Patients with a pre-existent indication for cardiac pacing were excluded.
  
  
  METHODS
  Suitability for an S-ICD defined as not reaching one of the following endpoints during follow-up: (1) an atrial and/or right ventricular pacing indication, (2) successful antitachycardia pacing without a subsequent shock or (3) an upgrade to a CRT-D device.
  
  
  RESULTS
  During a median follow-up of 3.4 years (IQR 1.7-5.7 years), 463 patients (34% of the total population of 1345 patients) reached an endpoint. The cumulative incidence of ICD recipients suitable for an initial S-ICD implantation was 55.5% (95% CI 52.0% to 59.0%) after 5 years. Significant predictors for the unsuitability of an S-ICD were: secondary prevention, severe heart failure and prolonged QRS duration.
  
  
  CONCLUSIONS
  After 5 years of follow-up, approximately 55% of the patients would have been suitable for an S-ICD implantation. Several baseline clinical characteristics were demonstrated to be useful in the selection of patients suitable for an S-ICD implantation.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Mihály K
authors.initials: MK
authors.lastname: de Bie
authors.forename: Joep
authors.initials: J
authors.lastname: Thijssen
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Rees
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Enno T
authors.initials: ET
authors.lastname: van der Velde
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Lieselot
authors.initials: L
authors.lastname: van Erven
mesh_terms: D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000150:complications / Q000401:mortality / Q000628:therapy*