The International Subcutaneous Implantable Cardioverter Defibrillator Registry (iSuSi)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Sudden Cardiac Death
- Sponsor
- University of Luebeck
- Enrollment
- 4000
- Locations
- 1
- Primary Endpoint
- Overall complication rate
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The entirely subcutaneous implantable defibrillator (S-ICD) (Emblem, Boston Scientific, Marlborough, MA, USA) was introduced as a new therapeutic alternative to the conventional transvenous ICD in 2009 and implantations are rapidly expanding since then.1 Implantation of the S-ICD seems to reduce implant-related perioperative complications such as pneumothorax, hematoma and cardiac tamponade.
The aim of this multicenter registry is thus to assess the outcome of patients following an S-ICD implantation in a real-world setting.
Detailed Description
The S-ICD has a CE mark and is FDA approved since 2012 and is mentioned as a potential therapy strategy in the current AHA guidelines on the management of patients with ventricular arrhythmias.2 However, although implant-related complications seem to be reduced by the S-ICD in randomized controlled trials, the rate of inappropriate shocks remains high in S-ICD patients (10-13%).3-5 The most common reason for inappropriate shocks is cardiac oversensing, mostly due to T-wave oversensing or low amplitude of the subcutaneous signal, which not commonly found in patients with transvenous ICDs. Data on the role of the Defibrillation Threshold Testing (DFT), the rate of infectious complications (lead or device complications), the use of the S-ICD in children and adolescents, and the outcome of patients with an S-ICD according to their underlying cardiac substrate are sparse. The aim of this multicenter registry is thus to assess the outcome of patients following an S-ICD implantation in a real-world setting with a special focus on perioperative complication rate, the role of DFT testing in S-ICD, the use of the S-ICD in cohorts that are underrepresented in clinical studies (adolescents and geriatrics), the outcome and risk factors of ineffective, inappropriate and appropriate shocks and the differences in outcomes according to the underlying cardiac disease.
Investigators
Prof. Roland Richard Tilz
Prof. Dr. med. Roland Richard Tilz
University of Luebeck
Eligibility Criteria
Inclusion Criteria
- •Implantation of an S-ICD, regardless of the technique
- •At least 1 month of follow up
- •At least 1 post-implantation assessment, in accordance to the routine clinical practice of every center (e.g. in person visit or remote follow up)
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Overall complication rate
Time Frame: through study completion, an average of 2 years
combination of device related complications and inappropriate shocks
Rate of inappropriate shocks
Time Frame: through study completion, an average of 2 years
Inappropriate therapies delivered by the devices
Rate of appropriate shocks
Time Frame: through study completion, an average of 2 years
Appropriate therapies delivered by the devices
Secondary Outcomes
- DFT impact(2 year)
- Device-related complication rate(immediately after the intervention/procedure/surgery")
- Role of Gender in primary outcomes(through study completion, an average of 2 year)
- Rate of device upgrades(through study completion, an average of 2 year)
- Rate of replacements(2 year)