Arrhythmias & electrophysiology
Efficacy and safety of the subcutaneous implantable cardioverter-defibrillator in patients with and without obesity: A meta-analysis
Authors' conclusion
Although S-ICD remains effective in obese patients, attention to potential technical challenges and higher complication rates is warranted.
Study context
- Population
- Subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with and without obesity
- Participants
- 20,486 recipients · 29 studies
- Comparison
- Obese vs nonobese S-ICD recipients
- Outcome
- Efficacy and safety outcomes of S-ICD by obesity/BMI
Methodological detailsrandom-effects
- Random-effects
Pooled result
As reported in the abstract
Mean difference, kg/m2 (95% CI)
Failed screening vs Successful screeningmean BMI; preimplantation screening
−0.60(−2.06 to 0.86)
Estimate (95% CI)
Obese vs Nonobesefailed defibrillation testing at ≤65 J
OR 2.16(1.39–3.35)
Obese vs Nonobesemalpositioning/suboptimal positioning
OR 3.37(1.76–6.44)
Per 1 kg/m² BMI increaseelevated defibrillation thresholds
OR 1.05(1.03–1.08)
Per 1 kg/m² BMI increaseappropriate shocks (trend)
HR 1.02(1.00–1.04)
Per 1 kg/m² BMI increaseinappropriate shocks (no significant increase)
HR 1.01(0.99–1.03)
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Complications | 1.04 (1.02–1.05) | |
| 0.512Hazard ratio (log scale) |
Original publication
Efficacy and safety of the subcutaneous implantable cardioverter-defibrillator in patients with and without obesity: A meta-analysis. Heart Rhythm. Published 15 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it