Subcutaneous ICDs: Pros and Cons

April 24, 2019 | Evaluations & Guidance


Conventional cardiac implantable electronic devices (CIEDs) rely on the use of transvenous leads to allow them to detect and terminate cardiac arrhythmias. While these leads are very efficient at transmitting the necessary signals and therapies, they are susceptible to complications, such as:

  1. Lead fracture or failure (lead failure has been reported at rates of 0.29% to 2.23% per year Providencia et al. 2015)

  2. Endocarditis, in which the leads introduce infections into the cardiac tissue, or systemic infection (infection has been reported in 1.5% of implantable cardioverter-defibrillator ICD patients Ezzat et al. 2015)

  3. Venous thrombosis (reported in 23% of pacemaker patients, though many events were subclinical van Rooden et al. 2004)

  4. Venous stenosis or occlusion due to inflammation (reported in 21.1% of 71 patients within six months of first device implantations Cacko et al. 2018)

  5. Cardiac perforation (reported in 0.16%...

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