Arrhythmias & electrophysiology
Differences in underlying cardiac substrate among subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients and its impact on long-term device-related outcomes: Real-world insights from the iSUSI registry
Authors' conclusion
Most S-ICD recipients were primary prevention nonischemic cardiomyopathy patients. Among those, patients with ARVC tend to receive the most frequent appropriate and inappropriate shocks and patients with BrS the least frequent appropriate shocks.
Study context
- Population
- S-ICD recipients in the i-SUSI registry
- Participants
- 1,698 recipients
- Exposure
- Ischemic vs nonischemic substrate among S-ICD recipients
- Outcome
- Rates of appropriate and inappropriate shocks and device-related complications
- Follow-up
- Median 26.5 (IQR 12.6-42.8) months
Methodological detailsinternational registry
- International registry
Main finding
As reported in the abstract
| Group | Appropriate shocks | Inappropriate shocks | Device-related complications |
|---|---|---|---|
| Ischemic | 4.8%/y | 3.0%/y | 6.4%/y |
| Nonischemic | 3.9%/y | 4.4%/y | 6.1%/y |
Appropriate shocks
Ischemic4.8%/y
Nonischemic3.9%/y
Inappropriate shocks
Ischemic3.0%/y
Nonischemic4.4%/y
Device-related complications
Ischemic6.4%/y
Nonischemic6.1%/y
- Ischemic vs Nonischemic: P = 0.282 — appropriate shocks; log-rank
- Nonischemic vs Ischemic: P = 0.043 — inappropriate shocks; log-rank
- Ischemic vs Nonischemic: P = 0.666 — device-related complications; log-rank
Observational data: associations, not effects.
Further findings
Appropriate shocks by substrate (subgroups)
| HR | P value | |
|---|---|---|
| ARVCHighest rate | 2.492 | P = 0.001 |
| BrSLowest rate | 0.396 | P = 0.008 |
Inappropriate shocks, arrhythmogenic right ventricular cardiomyopathy (ARVC) (subgroup)
| Adjusted HR (CI) | P value | ||
|---|---|---|---|
| ARVCHighest risk; unadjusted P = .001 | 2.243 (1.338–4.267) | P = 0.002 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Primary prevention indication
P = 0.037
- Appropriate shocks by substrate (subgroups): ARVC 9.0%/y
- Appropriate shocks by substrate (subgroups): Brugada syndrome (BrS) 1.8%/y
- Inappropriate shocks, ARVC (subgroup): ARVC 9.9%/y
Device-related complications by substrate
- No difference among underlying substrates (log-rank)
- P = 0.089
Original publication
Differences in underlying cardiac substrate among S-ICD recipients and its impact on long-term device-related outcomes: Real-world insights from the iSUSI registry. Heart Rhythm. Published 18 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →