Congenital heart diseaseCohort study
Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease
- Prospective cohort study
- nationwide
- multicentre
- propensity matching
Authors' conclusion
In this nationwide study, patients with CHD represented 2% of all S-ICD implantations. Our findings emphasize the effectiveness and safety of S-ICD in this particularly high-risk population.
Study context
- Population
- Patients receiving an S-ICD implant in 150 French centres, 2012–2019
- Participants
- 4,924 patients · 150 centres
- Exposure
- S-ICD in congenital heart disease (CHD) vs non-CHD patients
- CHDn = 101
Main finding
Appropriate S-ICD shock · mean follow-up 1.9 years
Hazard ratio
2.1
95% CI 1.3–3.4
By group
CHD vs Non-CHD
HR 2.1 (95% CI 1.3–3.4)
As reported in the abstract
- Association no longer significant after propensity matching (especially considering S-ICD indication)
- P = 0.12
- CHD patients with ≥1 appropriate shock; all shocks terminated the ventricular arrhythmia
- 16 (15.8%)
Observational data: associations, not effects.
Further findings
Characteristics at implantation, CHD vs non-CHD
Female CHD 37.6% · Non-CHD 23.0%
Secondary prevention CHD 72.3% · Non-CHD 35.9%
Severe systolic dysfunction of systemic ventricle CHD 28.1% · Non-CHD 53.1%
- Characteristics at implantation, CHD vs non-CHD: age (mean ± SD); all comparisons P < 0.001
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All complications | 1.2 (0.7–2.1) | P = 0.4 | |
| Inappropriate shocks | 0.9 (0.4–2.0) | P = 0.9 | |
| 0.512Hazard ratio (log scale) |
Original publication
Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease. J Am Coll Cardiol. Published 15 August 2023. doi:10.1016/j.jacc.2023.05.057
Summarised from the published abstract; every number is checked against it