Vol. 27 No. 1 (2023)
HEART RHYTHM DISORDERS

Subcutaneous versus transvenous cardioverter-defibrillators: 6-month follow-up

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  • A.V. Vereshchagina,
  • T.M. Uskach,
  • O.V. Sapelnikov,
  • V.A. Amanatova,
  • I.R. Grishin
A.V. Vereshchagina
Chazov National Medical Research Center of Cardiology
Bio
T.M. Uskach
Chazov National Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education
O.V. Sapelnikov
Chazov National Medical Research Center of Cardiology
V.A. Amanatova
Chazov National Medical Research Center of Cardiology
I.R. Grishin
Chazov National Medical Research Center of Cardiology
Patients changes in the condition and quality of life
DOI: https://doi.org/10.21688/1681-3472-2023-1-17-29

Published 2023-03-30

Keywords

  • Death, Sudden, Cardiac,
  • Defibrillators, Implantable,
  • Follow-Up Studies,
  • Heart Failure,
  • Surveys and Questionnaires

How to Cite

Vereshchagina, A., Uskach, T., Sapelnikov, O., Amanatova, V., & Grishin, I. (2023). Subcutaneous versus transvenous cardioverter-defibrillators: 6-month follow-up. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 27(1), 17–29. https://doi.org/10.21688/1681-3472-2023-1-17-29

Copyright (c) 2023 Vereshchagina A.V., Uskach T.M., Sapelnikov O.V., Amanatova V.A., Grishin I.R.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Objective: To evaluate the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators versus transvenous implantable cardioverter-defibrillators during 6-month follow-up.
Methods: The prospective research successively included 95 patients with indications for primary prevention of sudden cardiac death. The patients were divided into 2 groups: group 1 — 52 patients with subcutaneous implantable cardioverter-defibrillators, group 2 — 43 patients with transvenous implantable cardioverter-defibrillators. The patients were followed up for 6 months. All episodes of applied shock therapy, complications, patients changes in the condition and quality of life were analyzed.
Results: The groups were initially comparable in terms of gender, age, etiology of the disease, and severity of the condition. Male patients prevailed (subcutaneous implantable cardioverter-defibrillators — 90.3%, transvenous implantable cardioverter-defibrillators — 93.0%), the mean age for subcutaneous devices was 56 [49;62] years and 60 [54;65] years for transvenous implantable cardioverter-defibrillators. All patients had chronic heart failure. The median LV EF for subcutaneous implantable cardioverter-defibrillator and transvenous implantable cardioverter-defibrillator was 29% [26;32] and 30% [27;32], respectively, EDV — 220 mL [187;278] and 202 mL [186;248], ESV — 151 mL [126;188] and 145 mL [122;184]. The number of complications recorded during the 6-month follow-up was slightly higher in patients who were implanted with subcutaneous implantable cardioverter-defibrillator (subcutaneous implantable cardioverter-defibrillators — 7.6%, transvenous implantable cardioverter-defibrillators — 2.3%, p = 0.249). The incidence of inadequate shocks in the groups was comparable (7.7% for subcutaneous implantable cardioverter-defibrillators, 6.9% for transvenous implantable cardioverter-defibrillators, p = 0.882). The percentage of using adequate shock therapy was higher in the transvenous implantable cardioverter-defibrillator group, 18.6% versus 5.7% in the subcutaneous implantable cardioverter-defibrillator group (p = 0.051). Implantation of the devices (both subcutaneous and transvenous) improved quality of life according to the results of questionnaires (Minnesota and EQ-5D questionnaires) before implantation and after 6 months of follow-up (p < 0.001 in both groups).
Conclusion: This research demonstrates comparable results for the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators compared with transvenous implantable cardioverter-defibrillators in patients with the need for primary prevention of sudden cardiac death within 6 months.

Received 6 October 2022. Revised 28 February 2023. Accepted 1 March 2023.

Funding: The study did not have sponsorship.

Conflict of interest: The authors declare no conflict of interest.

Contribution of the authors
Conception and study design: A.V. Vereshchagina, T.M. Uskach, O.V. Sapelnikov
Data collection and analysis: A.V. Vereshchagina, V.A. Amanatova, I.R. Grishin
Statistical analysis: A.V. Vereshchagina, V.A. Amanatova
Drafting the article: A.V. Vereshchagina, T.M. Uskach
Critical revision of the article: A.V. Vereshchagina, T.M. Uskach, O.V. Sapelnikov
Final approval of the version to be published: A.V. Vereshchagina, T.M. Uskach, O.V. Sapelnikov, V.A. Amanatova, I.R. Grishin

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