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Heart Rhythm 2012

Examining Criteria for ICD Primary Prevention Therapy The Particulars: Studies have suggested that nearly 25% of implantable cardioverter-defibrillators (ICDs) for primary prevention are implanted outside of evidence-based criteria. Currently, there is little information comparing the long-term outcomes among patients receiving ICDs within evidence-based guidelines and those outside of such criteria. Data Breakdown: A retrospective analysis of patients who received ICDs for primary prevention found that those who received their device outside of evidence-based criteria experienced similar results to those within such criteria. Similar findings were observed in time to first appropriate ICD therapy, risk of death, and time of first inappropriate ICD therapy. Take Home Pearl: Patients who receive ICDs for primary prevention outside of evidence-based criteria appear to experience similar therapeutic benefits and outcomes as patients who receive their device within evidence-based criteria. Real-World Results With Subcutaneous ICD The Particulars: The Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) System does not require the intravascular leads used in typical transvenous implantable cardioverter-defibrillator (ICD) procedures. The device is inserted under the skin and outside the ribcage of patients at risk for sudden cardiac arrest (SCA). Long-term performance of the S-ICD System, including patient quality of life and long-term resource use, has yet to be studied. Data Breakdown: Researchers reviewed the real-world experiences of 230 recipients of the S-ICD System in nine countries. They found a conversion rate of more than 98% for induced and ambulatory ventricular tachycardia or fibrillation. No patients received therapy for any supraventricular tachycardia within a programmed conditional shock zone. Take Home Pearl: According to real-world experiences, the S-ICD System appears to be a safe and effective option for most...
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