Algorithm-Based Screening May Improve Patient Selection for the Subcutaneous Implantable Defibrillator

JACC. Clinical Electrophysiology
T F BrouwerReinoud E Knops

Abstract

The study sought to describe the concept of algorithm-based screening with an external subcutaneous implantable cardioverter-defibrillator (S-ICD) to evaluate sensing using the rhythm discrimination algorithm of the device. In a proportion of patients, screening for S-ICD therapy with the dedicated screening tool results in false negative and false positive results. Both patients who failed the standard screening and who passed with abnormal baseline ECGs were screened with an external S-ICD to evaluate sensing at rest and during exercise in all 3 sensing vectors (algorithm-based screening). Patients with adequate sensing were implanted with an S-ICD. Follow-up data regarding (in)appropriate shocks was collected. Algorithm-based screening was performed in 15 patients. Group 1 consists of 8 who failed standard screening and Group 2 consists of 7 who passed and had abnormal ECGs. Six of 8 who failed standard screening in all sensing vectors demonstrated adequate sensing with the external S-ICD and were implanted with an S-ICD. Of these 6 implanted patients in Group 1, 1 inappropriate shock was observed duration median of 17 months' follow-up and 2 episodes of ventricular fibrillation were successfully treated. Of the 7 patients i...Continue Reading

References

Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Jan 22, 2005·The New England Journal of Medicine·Gust H BardyUNKNOWN Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators
Sep 24, 2005·Pacing and Clinical Electrophysiology : PACE·Peter AlterWolfram Grimm
Oct 8, 2009·Circulation. Arrhythmia and Electrophysiology·C Jan Willem BorleffsMartin J Schalij
May 14, 2010·The New England Journal of Medicine·Gust H BardyAndrew A Grace
Dec 11, 2013·Journal of Cardiovascular Electrophysiology·Louise R A Olde NordkampReinoud E Knops
Dec 11, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Kirsten M KooimanJoris R de Groot
Dec 20, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Daniel A RandlesDavid J Wright
Apr 24, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Christopher A GrohBradley P Knight
Jan 13, 2015·Journal of Cardiovascular Electrophysiology·Amy J BrisbenMichael R Gold

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