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Auricchio A, Sterns LD, Schloss EJ, et al. Performance evaluation of implantable cardioverter-defibrillators with SmartShock technology in patients with inherited arrhythmogenic diseases. Int J Cardiol. 2022;doi: 10.1016/j.ijcard.2022.01.007.
Auricchio, A., Sterns, L. D., Schloss, E. J., Gerritse, B., Lexcen, D. R., Molan, A. M., Kurita, T. (2022). Performance evaluation of implantable cardioverter-defibrillators with SmartShock technology in patients with inherited arrhythmogenic diseases. International journal of cardiology, . https://doi.org/10.1016/j.ijcard.2022.01.007
Auricchio, Angelo, et al. "Performance evaluation of implantable cardioverter-defibrillators with SmartShock technology in patients with inherited arrhythmogenic diseases." International journal of cardiology vol. (2022). doi: https://doi.org/10.1016/j.ijcard.2022.01.007
Auricchio A, Sterns LD, Schloss EJ, Gerritse B, Lexcen DR, Molan AM, Kurita T. Performance evaluation of implantable cardioverter-defibrillators with SmartShock technology in patients with inherited arrhythmogenic diseases. Int J Cardiol. 2022 Jan 06; doi: 10.1016/j.ijcard.2022.01.007. Epub 2022 Jan 06. PMID: 34998948.
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Int J Cardiol. 2022 Jan 06; doi: 10.1016/j.ijcard.2022.01.007. Epub 2022 Jan 06.

Performance evaluation of implantable cardioverter-defibrillators with SmartShock technology in patients with inherited arrhythmogenic diseases.

International journal of cardiology

Angelo Auricchio, Laurence D Sterns, Edward J Schloss, Bart Gerritse, Daniel R Lexcen, Amy M Molan, Takashi Kurita,

Affiliations

  1. Division of Cardiology, Istituto Cardiocentro Ticino, Lugano, Switzerland. Electronic address: [email protected].
  2. Vancouver Island Arrhythmia Clinic, Victoria, BC, Canada.
  3. The Christ Hospital, Cincinnati, OH, USA.
  4. Medtronic Bakken Research Center, Maastricht, Netherlands.
  5. Medtronic plc, Mounds View, MN, USA.
  6. Division of Cardiovascular Center, Kindai University, School of Medicine, Japan.

PMID: 34998948 DOI: 10.1016/j.ijcard.2022.01.007

Abstract

BACKGROUND: Patients with inherited arrhythmogenic diseases (IADs) are often prescribed preventative implantable cardioverter-defibrillators (ICDs) to manage their increased sudden cardiac arrest risk. However, it has been suggested that ICDs in IAD patients may come with additional risk. We aimed to leverage the PainFree SmartShock Technology dataset to compare inappropriate therapies, appropriate therapies, mortality, and complications in patients with and without IAD.

METHODS: This retrospective analysis included extracted, physician-adjudicated, arrhythmic episodes from ICD devices. The incidence of arrhythmic events was estimated with the Kaplan-Meier method using the log-rank test. Cox proportional hazards regression was used to estimate hazard ratios (HRs) with their 95% confidence intervals (CIs).

RESULTS: Of the 1699 ICD patients, 77 patients (4.5%) had IAD. Incidence of inappropriate shock was similar in both patients with (3.2% at 24 months) and without (3.8% at 24 months) IAD (HR: 0.80, CI: 0.19-3.30, p = 0.76). In a multivariable analysis IAD was not significantly associated with reduced mortality (HR: 0.64, CI: 0.08-4.80, p = 0.66). The rates of complications were numerically lower in patients with IAD vs without (8.8% vs 9.6% at 24 months respectively), but not statistically significant (HR: 0.83, CI: 0.20-3.38, p = 0.79).

CONCLUSIONS: IAD patients showed a very low annual rate of inappropriate therapy. This suggests that newer algorithms, such as the SST algorithm, are equally good at identifying and treating life-threatening arrhythmias in patients regardless of whether they have IAD.

Copyright © 2022 Elsevier B.V. All rights reserved.

Keywords: Inappropriate shock; Inherited arrhythmogenic diseases; SmartShock technology; Sudden cardiac arrest

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