Arrhythmias & electrophysiology
Impact of Median Sternotomy on Safety and Efficacy of the Subcutaneous Implantable Cardioverter Defibrillator
Authors' conclusion
Sternotomy before or after S-ICD does not confer additional risk relative to a historical control group without sternotomy.
Study context
- Population
- Patients with S-ICD undergoing sternotomy before or after implantation52±16 years, 47 women
- Participants
- 196 patients
- Exposure
- Sternotomy before or after S-ICD vs historical nonsternotomy controls
- S-ICD after sternotomyn = 166
- Sternotomy after S-ICDn = 30
- Outcome
- S-ICD lead damage during sternotomy, inappropriate shocks from sternal-wire noise, and failure to terminate spontaneous or induced ventricular arrhythmias
Methodological detailsmulticentre, historical control cohort
- Multicentre
- Historical control cohort
Main finding
As reported in the abstract
S-ICD first shocks successfully terminated spontaneous ventricular arrhythmias
31 of 32 patients
97%
Defibrillation threshold testing at implant: first shock success
91%
Inappropriate shocks (most commonly T wave oversensing, n=14)
22 patients
Observational data: associations, not effects.
Safety
Inappropriate shocks · median follow-up 29 months
- Patients with inappropriate shocks
- 22
- Related to T wave oversensing
- 14
- No difference vs nonsternotomy controls
Original publication
Impact of Median Sternotomy on Safety and Efficacy of the Subcutaneous Implantable Cardioverter Defibrillator. Circ Arrhythm Electrophysiol. Published 24 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →