The use of a subcutaneous implantable cardioverter-defibrillator (S-ICD) has been expanding in Poland since 2014. The Polish Registry of S-ICD Implantations was held by the Heart Rhythm Section of the Polish Cardiac Society between May 2020 and September 2022 to monitor the implementation of that therapy in Poland.
To investigate and present the state-of-the-art of S-ICD implantation in Poland.
Implanting centers reported clinical data of patients undergoing S-ICD implantations and replacements, including: age, gender, height, weight, underlying disease, history of pacemaker and defibrillator implantations, indications for S-ICD, electrocardiographical parameters, procedural techniques, and complications.
440 patients undergoing S-ICD implantation (411) or replacement (29) were reported by 16 centers. Most patients were in New York Heart Association class II (218 patients, 53%) or I (150 patients, 36.5%). Left ventricular ejection fraction was 10-80%, median (IQR) 33% (25%‒55%). Primary prevention indications were present in 273 patients (66.4%). Non-ischemic cardiomyopathy was reported in 194 patients (47.2%). The main reason for the choice of S-ICD were: young age (309, 75.2%), risk of infective complications (46, 11.2%), prior infective endocarditis (36, 8.8%), hemodialysis (23, 5.6%), and immunosuppressive therapy (7, 1.7%). Electrocardiographic screening was performed in 90% of patients. The rate of adverse events was low (1.7%). No surgical complications were observed.
Qualification for S-ICD in Poland was slightly different when compared to the rest of Europe. The implantation technique was mostly consistent with the current guidelines. S-ICD implantation was safe, and the complication rate was low.