title: First clinical experience of the safety and feasibility of total subcutaneous implantable defibrillator in an Asian population.
abstract: OBJECTIVE
  The safety and feasibility of a subcutaneous implantable cardioverter-defibrillator (S-ICD) has been demonstrated in the treatment of life-threatening ventricular tachyarrhythmias (VT). Nonetheless, its safety and feasibility in an Asian population with smaller body-build is unclear.
  
  
  RESULTS
  Twenty-one Asian patients who underwent S-ICD from 1 April 2014 to 2 February 2015 in five institutions in Hong Kong and Singapore were retrospectively reviewed. Twenty-one patients with a mean age of 50.0 ± 14.1 years (range 29-77 years, 82.6% male) were included. Among them, 17 (81.0%) were Chinese, 3 (14.3%) were Malay, and 1 (4.8%) was Indian. Their mean body mass index was 23.0 ± 4.0 kg/m(2). An S-ICD was implanted for primary and secondary prevention in 13 (61.9%) and 8 (38.1%) patients, respectively. The indications included Brugada syndrome (n = 6, 28.6%), ischaemic cardiomyopathy (CMP, n = 6, 28.6%), dilated CMP (n = 4, 19.0%), hypertrophic CMP (n = 2, 9.5%), and idiopathic ventricular fibrillation (n = 2, 9.5%). Three patients (14.3%) had prior infected transvenous ICD. There were no acute complications but eight wound complications (persistent wound bleeding requiring intervention = 2; delayed wound healing: upper sternal wound = 3; generator site = 1; local wound infection = 2) were observed in six (28.2%) patients. After a mean follow-up of 107.2 ± 81.3 days (range of 14-254 days), one patient underwent three successful appropriate shocks for treatment of VTs. No inappropriate therapy was documented.
  
  
  CONCLUSIONS
  Our initial experience shows that S-ICD is a feasible treatment for VT among an Asian population with smaller body-build. There was nonetheless a relatively high rate of wound complications.
authors: Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
authors: Jo Jo
authors: JJ
authors: Hai
authors: Department of Cardiology, National Heart Center Singapore, Singapore.
authors: Eric Tien-Siang
authors: ET
authors: Lim
authors: Cardiology Division, Department of Medicine, Prince of Wales Hospital, Hong Kong.
authors: Chin-Pang
authors: CP
authors: Chan
authors: Cardiology Division, Department of Medicine, Prince of Wales Hospital, Hong Kong.
authors: Yat-Sun
authors: YS
authors: Chan
authors: Cardiology Division, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
authors: Kwok-Keung
authors: KK
authors: Chan
authors: Department of Cardiology, National Heart Center Singapore, Singapore.
authors: Daniel
authors: D
authors: Chong
authors: Department of Cardiology, National Heart Center Singapore, Singapore.
authors: Kah-Leng
authors: KL
authors: Ho
authors: Department of Cardiology, National Heart Center Singapore, Singapore.
authors: Boon-Yew
authors: BY
authors: Tan
authors: Department of Cardiology, National Heart Center Singapore, Singapore.
authors: Wee-Siong
authors: WS
authors: Teo
authors: Department of Cardiology, National Heart Center Singapore, Singapore hftse@hkucc.hku.hk ching.chi.keong@nhcs.com.sg.
authors: Chi-Keong
authors: CK
authors: Ching
authors: Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Research Center of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong hftse@hkucc.hku.hk ching.chi.keong@nhcs.com.sg.
authors: Hung-Fat
authors: HF
authors: Tse
mesh_terms: D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004867:Equipment Design; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000517:prevention & control*; D006723:Hong Kong; D006801:Humans; D008297:Male; D061214:Patient Safety; D010865:Pilot Projects; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012846:Singapore; D016896:Treatment Outcome
keywords: Asian; Feasibility; Safety; Subcutaneous implantable cardioverter-defibrillator