Duration of hospital admission, need of on-demand analgesia and other peri-procedural and short-term outcomes in sub-cutaneous vs. transvenous implantable cardioverter-defibrillators

Int J Cardiol. 2018 May 1:258:133-137. doi: 10.1016/j.ijcard.2017.11.104.

Abstract

Background: Post-procedural recovery following sub-cutaneous ICD (S-ICD) implantation is feared to be more painful and to require more prolonged hospital admission. The purpose of this study was to compare peri-procedural and short clinical outcomes of the S-ICD vs. the Transvenous ICD (TV-ICD).

Methods: We conducted a single-center cross-sectional study including all consecutive patients who underwent S-ICD implantation by the same operator since January 2016 and a gender and age-matched control group with all single chamber TV-ICD implanted patients over a contemporary time period.

Results: Thirty-one patients (sex ratio 1/5; mean age 58.7±13.2years) with S-ICD were compared to 31 matched TV-ICD patients. Duration of the implant procedure was significantly longer for the S-ICD (58.0±24.4min vs 41.7±20.8min TV-ICD, p<0.01). Mean fluoroscopy time for the TV-ICD was 3.5±3.6min vs 0.1±0.01min for all S-ICD patients (p<0.01). Requirement of on-demand analgesia administration, and duration of hospitalization (1.5days for both groups; p=NS) were similar in the two groups. No peri-procedural events were reported, and after a mean follow-up of 6months, the only complication was a pocket infection requiring reintervention in the TV-ICD group.

Conclusions: The S-ICD appears to be as effective and safe as the conventional single chamber TV-ICD. Duration of hospital admission and need of on-demand analgesia are also comparable for S-ICD patients.

Keywords: Duration of hospitalization; Matched comparison; Pain assessment; Short term clinical outcomes; Subcutaneous implantable defibrillator; Transvenous ICD.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Analgesia / trends*
  • Anesthesia, General / trends*
  • Cross-Sectional Studies
  • Defibrillators, Implantable / adverse effects
  • Defibrillators, Implantable / trends*
  • Electric Countershock / adverse effects
  • Electric Countershock / instrumentation
  • Electric Countershock / trends*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Admission / trends*
  • Subcutaneous Tissue
  • Time Factors
  • Treatment Outcome