Outcomes are comparable in older patients receiving a subcutaneous implantable cardioverter-defibrillator (S-ICD) or a transvenous ICD (TV-ICD), according to an international study.
More than 16,000 patients were identified from a cardiovascular data registry, were ≥65 years (mean 72 years), and underwent ICD implantation between 2012 and 2017.
The study, published in the Journal of the American College of Cardiology, found no significant difference between the groups in the primary outcome of all-cause mortality (HR 1.02) over a median follow-up of 2.3 years.
Similarly, secondary outcomes of all-cause readmission (HR 1.072), device reoperation (HR 0.976), device removal caused by infection (HR 0.614), device reoperation without infection (HR 0.975), and cardiovascular readmission (HR 1.087) were not statistically different between the groups.
“These findings support the use of the S-ICD as an option for the prevention of sudden cardiac death in appropriately selected older patients,” said the study authors, including Dr Dr Isuru Ranasinghe, Senior Staff Specialist Cardiologist at the Prince Charles Hospital, Brisbane.
“The S-ICD obviates the need for intravascular or intracardiac leads, which limits certain ICD complications such as short-term cardiac perforation and long-term intravascular device infection and lead dislodgement.”
The study showed that the S-ICD patients were more often Black (18.1% vs 12.4%), younger (71.0 vs 72.7 years), dialysis dependent (22.9% vs 2.1%), and less likely to have atrial fibrillation or flutter (26.9% vs 33.4%).