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DEVICE THERAPY

Subcutaneous ICD noninferior to transvenous ICD

Nature Reviews Cardiology volume 17, page 678 (2020)Cite this article

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The subcutaneous implantable cardioverter–defibrillator (ICD) is noninferior to the transvenous ICD for the risk of device-related complications and inappropriate shocks, according to the PRAETORIAN trial. Subcutaneous ICDs, which are placed outside the thorax in the subcutaneous tissue, were developed to avoid the complications associated with transvenous ICD leads. However, concerns were raised about their defibrillation efficacy and the risk of inappropriate shocks. The PRAETORIAN trial included 849 patients with an ICD indication but no indication for pacing who were randomly assigned to receive a subcutaneous or transvenous ICD. At 48 months, the estimated cumulative incidence of device-related complications or inappropriate shocks was similar in both groups (15.1% versus 15.7%; HR 0.99, 95% CI 0.71–1.39, P = 0.01 for noninferiority). Device-related complications were more common with the transvenous ICD, whereas inappropriate shocks were more common with the subcutaneous ICD. All-cause mortality was not significantly different between the groups.

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References

Original article

  • Knops, R. E. et al. Subcutaneous or transvenous defibrillator therapy. N. Engl. J. Med. 383, 526–536 (2020)

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  1. Nature Reviews Cardiology http://www.nature.com/nrcardio/

    Irene Fernández-Ruiz

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  1. Irene Fernández-Ruiz
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Correspondence to Irene Fernández-Ruiz.

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Fernández-Ruiz, I. Subcutaneous ICD noninferior to transvenous ICD. Nat Rev Cardiol 17, 678 (2020). https://doi.org/10.1038/s41569-020-00440-0

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  • DOI: https://doi.org/10.1038/s41569-020-00440-0

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