Efficacy and Complications of Subcutaneous versus Conventional Cardioverter Defibrillators: A Systematic Review and Meta-analysis

Implantable cardioverter defibrillators are used to prevent sudden cardiac death. The subcutaneous implantable cardioverter-defibrillator was newly developed to overcome the limitations of the conventional implantable cardioverter defibrillator-transvenous device. The subcutaneous implantable cardio...

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Bibliographic Details
Published in:Current cardiology reviews 2022-01, Vol.18 (3), p.e081221198647-e081221198647
Main Authors: Araújo, Camilla Silva, Silva, Carla Liz Barbosa, da Silva Menezes Júnior, Antônio, Barbosa, Vinícius Araújo, de Almeida Laranjeira, Tiago, Fernandes, Joaquim Ferreira, Gonçalves, Lucas Cândido, Silva, Antonio Márcio Cordeiro
Format: Article
Language:English
Subjects:
Arrhythmia
Arrhythmias, Cardiac - therapy
Cardiovascular diseases
Clinical trials
Complications
Coronary artery disease
Death, Sudden, Cardiac - etiology
Death, Sudden, Cardiac - prevention & control
Defibrillators
Defibrillators, Implantable - adverse effects
Electrocardiography
Electrodes
Heart diseases
Hematoma
Humans
Infections
Meta-analysis
Patients
Systematic review
Tachycardia
Tachycardia, Supraventricular
Treatment Outcome
Ventricle
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Summary:Implantable cardioverter defibrillators are used to prevent sudden cardiac death. The subcutaneous implantable cardioverter-defibrillator was newly developed to overcome the limitations of the conventional implantable cardioverter defibrillator-transvenous device. The subcutaneous implantable cardioverter defibrillator is indicated for young patients with heart disease, congenital heart defects, and poor venous access, who have an indication for implantable cardioverter defibrillator without the need for anti-bradycardic stimulation. We aimed to compare the efficacy and complications of subcutaneous with transvenous implantable cardioverter- defibrillator devices. A systematic review was conducted using different databases. The inclusion criteria were observational and clinical randomized trials with no language limits and no publication date limit that compared subcutaneous with transvenous implantable cardioverter-defibrillators. The selected patients were aged > 18 years with complex ventricular arrhythmia. Five studies involving 2111 patients who underwent implantable cardioverter defibrillator implantation were included. The most frequent complication in the subcutaneous device group was infection, followed by hematoma formation and electrode migration. For the transvenous device, the most frequent complications were electrode migration and infection. Regarding efficacy, the total rates of appropriate shocks were 9.04% and 20.47% in the subcutaneous and transvenous device groups, respectively, whereas inappropriate shocks to the subcutaneous and transvenous device groups were 11,3% and 10,7%, respectively. When compared to the transvenous device, the subcutaneous device had lower complication rates owing to lead migration and less inappropriate shocks due to supraventricular tachycardia; nevertheless, infection rates and improper shocks due to T wave oversensing were comparable for both devices CRD42021251569.
ISSN:1573-403X
1875-6557
DOI:10.2174/1573403X17666211208100151