S-ICD suitable for some patients who have had device infections

7th January 2016

Subcutaneous internal defibrillators (S-ICDs) are a suitable alternative for some people who have had to have their conventional ICDs removed, including for infection problems.

That is the conclusion of a study from a team of international experts, including Dr Pier Lambiase from the Barts Heart Centre in London.

ICDs are given to people thought to be at risk of a life-threatening heart rhythm as they can shock the heart back into a normal rhythm.

But unlike a conventional ICD, the S-ICD does not have leads going into the heart. Because of this it is unable to pace the heart if the heart rate becomes too slow. So it is only suitable for people who show no evidence of heart failure and have no need for a pacemaker.

Because the leads are outside the heart, complications that can occur with conventional ICDs leads, such as infections are reduced.

The researchers were looking at how safe an S-ICD was for people after having their conventional ICDs taken out.

Patients were divided into three groups: those who had had their conventional ICD taken out for infection problems, those who had had the device taken out for others reasons, and those who had not previously had an ICD.

After nearly two years, major infection after S-ICD implantation was low in all groups, with no evidence that patients who had had their previous ICD removed because of infection were more likely to experience a subsequent reinfection.

The researchers concluded that in suitable patients an S-ICD was a viable alternative for patients whose conventional devices had been taken out for any reason. Risk of infection remained low.

Ref: Infection and mortality after implantation of a subcutaneous ICD after transvenous ICD extraction.