Premium
Mechanisms and management of inappropriate therapy in subcutaneous implantable cardioverter defibrillators
Author(s) -
Karnik Ankur A.,
Helm Robert H.,
Monahan Kevin M.
Publication year - 2019
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13831
Subject(s) - medicine , implantable cardioverter defibrillator , defibrillation , brugada syndrome , cardiology , supraventricular tachycardia , intensive care medicine , ventricular tachycardia , sudden cardiac death , cardiomyopathy , tachycardia , hypertrophic cardiomyopathy , heart failure
Subcutaneous implantable cardioverter defibrillators (S‐ICDs) provide reliable defibrillation and have enhanced supraventricular tachycardia discrimination and fewer infection rates compared with traditional transvenous systems. However, inappropriate shocks remain a frequent problem. Herein, we review the various mechanisms of these inappropriate therapies, some of which are unique to S‐ICDs, and propose an algorithm for preventing recurrences. Proper screening of preimplants is essential to help minimize inappropriate therapies, but patients with hypertrophic cardiomyopathy, Brugada syndrome, and arrhythmogenic right ventricular cardiomyopathy are at particular risk and may require additional measures.