title: Long-time "real-life" performance of the subcutaneous ICD in patients with electrical heart disease or idiopathic ventricular fibrillation.
abstract: BACKGROUND
  The totally subcutaneous implantable defibrillator (S-ICD) has been designed as a new alternative to conventional implantable defibrillators. This system is especially attractive for young patients. However, long-term experience is not yet available. To address the question whether the S-ICD system is safe and feasible for young patients with electrical heart disease or idiopathic ventricular fibrillation (VF), the data of a standard of care prospective single center S-ICD registry were evaluated.
  
  
  METHODS
  In the present study, 24 patients (age 34.2 ± 11.5 years) with electrical heart disease or idiopathic VF received an S-ICD for primary (n = 8) or secondary prevention (n = 16). The mean follow-up duration was 29.6 ± 15.1 months.
  
  
  RESULTS
  Ventricular arrhythmias were adequately detected in four patients (17 %). In three patients (13 %) oversensing was noticed and led to at least one inappropriate shock in two patients (8 %). Further adverse events included surgical revision due to a mobile pulse generator as well as explantation of one system and switch to a transvenous ICD system due to several ineffective shocks.
  
  
  CONCLUSIONS
  The results of the present study suggest that S-ICD therapy may be an attractive alternative in young patients with electrical heart disease or idiopathic VF. However, episodes of oversensing as well as ineffective shocks may occur.
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany. gerrit.frommeyer@ukmuenster.de.
authors.forename: Gerrit
authors.initials: G
authors.lastname: Frommeyer
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Dirk G
authors.initials: DG
authors.lastname: Dechering
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Kochhäuser
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Bettin
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Köbe
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Reinke
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000517:prevention & control*
keywords: Device complications; Electrical heart disease; Idiopathic ventricular fibrillation; S-ICD; Sudden cardiac death