Arrhythmias & electrophysiology
Subcutaneous ICD therapy in patients with monomorphic ventricular tachycardia: Arrhythmia recurrence, shock rate, and management strategies
Authors' conclusion
In patients with previous MVT, the S-ICD provided safe and effective protection against ventricular arrhythmias. Ablation was the preferred management strategy, and no patients required conversion to a transvenous device. These findings support the use of the S-ICD as a viable option in this patient population.
Study context
- Population
- Patients with a history of sustained monomorphic ventricular tachycardia (MVT) receiving de novo S-ICD implantationidentified from 2164 consecutive de novo S-ICD implantations (10%)
- Participants
- 210 patients
Methodological detailsconsecutive de novo
- Consecutive de novo
Main finding
As reported in the abstract
Sustained MVT recurrence · median follow-up of 43 months (interquartile range 21-70)
Patients experiencing MVT episodes
21 patients
10%
MVT episodes (60 isolated, 6 storms)
66
Total ventricular arrhythmic episodes, all successfully terminated by shocks
98
Annualized rate of MVT
2.8%/y
Further findings
Appropriate shocks
- Rate of appropriate shocks
- 4.9%/y
- First-shock efficacy for both MVT and polymorphic ventricular tachycardia/ventricular fibrillation
- 93%
Management of recurrent MVT
- Approximately half of patients with recurrent MVT underwent ablation, with high procedural success
- No patient required S-ICD explantation or conversion to a transvenous implantable cardioverter-defibrillator for antitachycardia pacing (ATP) delivery
Safety
Complications and inappropriate shocks
- Complication rate
- 2.3%/y
- Inappropriate shock rate
- 2.8%/y
Original publication
Subcutaneous ICD therapy in patients with monomorphic ventricular tachycardia: Arrhythmia recurrence, shock rate, and management strategies. Heart Rhythm. Published 25 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it