Journal article
Outcomes of subcutaneous implantable cardioverter-defibrillator in dialysis patients: Results from the S-ICD post-approval study
HEART RHYTHM, v 17(9), pp 1566-1574
Sep 2020
PMID: 32376304
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND Patients with chronic renal disease on hemodialysis (HD) have limited vascular access and are at high risk of bacteremia. The subcutaneous implantable cardioverter-defibrillator (S-ICD) avoids vascular access, so it may be advantageous in this patient population. OBJECTIVE The purpose of this study was to report outcomes of patients with end-stage renal disease enrolled in the multicenter S-ICD post-approval study (PAS). METHODS S-ICD PAS patients were stratified on the basis of the presence (group 1) or absence (group 2) of HD at the time of implantation. Baseline demographic and clinical characteristics were collected. Perioperative and intermediate-term outcomes 365 days postimplantation were compared between the 2 groups. RESULTS There were 220 patients on HD (13.4%) at the time of implantation out of 1637 patients enrolled in the S-ICD PAS. Patients on HD (group 1) were older (57.4 +/- 13.2 years vs 52.5 +/- 15.2 years; P < .0001), more likely to be of African descent (48.6% vs 25.1%; P < .0001), and had lower ejection fraction (28.6% +/- 11.3% vs 32.6% +/- 14.9%; P < .0001) as compared with patients not on HD (group 2). Group 1 had more comorbidities and mortality was higher (17.4% vs 3.7%) than did group 2. The rate of complications calculated using the Kaplan-Meier estimate did not differ between the 2 groups (overall P = .9169), with a 1-year rate of 7.9% and 7.7% for groups 1 and 2, respectively. The rate of appropriate shocks was significantly higher in group 1 (Kaplan-Meier analysis, P = .0003), as was inappropriate shocks (P = .0137). CONCLUSION S-ICD is associated with similar adverse event rates but a higher risk of inappropriate and appropriate therapy in dialysis patients than in nondialysis patients.
Metrics
Details
- Title
- Outcomes of subcutaneous implantable cardioverter-defibrillator in dialysis patients: Results from the S-ICD post-approval study
- Publication Details
- HEART RHYTHM, v 17(9), pp 1566-1574
- Publisher
- ELSEVIER SCIENCE INC; NEW YORK
- Number of pages
- 0
- Grant note
- This study was supported by Boston Scientific. Dr El-Chami has received compensation for services from Boston Scientific and Medtronic. Dr Burke has received compensation for services from Boston Scientific and Biosense Webster and has equity interest in AtaCor Medical. Dr Herre has received compensation for services from Medtronic, Abbott, LifeNet Health, EBR, and Boston Scientific. Dr Shah has received compensation for services from Boston Scientific. Dr Sadhu has received compensation for services from Boston Scientific, royalties from Medtronic, and nonroyalties from Boston Scientific and Abbott. Dr Niebauer has received compensation for services from Acutus, Medtronic, and Boston Scientific. Dr Kutalek has received compensation for services and research and fellowship grants from Boston Scientific. Dr Gold has received compensation for services from Boston Scientific and Medtronic. Dr Carter reports no conflicts of interest. Trial Registration: clinicaltrials.gov Identifier: NCT01736618.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000566333900023
- Scopus ID
- 2-s2.0-85089505889
- Other Identifier
- 991021860769804721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems