Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry
<b>Background:</b> The advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) marked a significant milestone in the course of cardiac rhythm devices, particularly for patients who are deemed at high risk for ventricular arrhythmias and sudden cardiac death. This extracar...
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2025-06-01
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| author | Nikias Milaras Evangelos Oikonomou Konstantinos P. Letsas Nikolaos Ktenopoulos Sotirios Xydonas Panagiotis Korantzopoulos Georgios Leventopoulos Panagiotis Dourvas Stefanos Archontakis Athena Batsouli Panagiotis Mililis Athanasios Saplaouras Emmanuel Kanoupakis Konstantinos Toutouzas Stylianos Paraskevaidis Michalis Efremidis Skevos Sideris |
| author_facet | Nikias Milaras Evangelos Oikonomou Konstantinos P. Letsas Nikolaos Ktenopoulos Sotirios Xydonas Panagiotis Korantzopoulos Georgios Leventopoulos Panagiotis Dourvas Stefanos Archontakis Athena Batsouli Panagiotis Mililis Athanasios Saplaouras Emmanuel Kanoupakis Konstantinos Toutouzas Stylianos Paraskevaidis Michalis Efremidis Skevos Sideris |
| author_sort | Nikias Milaras |
| collection | DOAJ |
| description | <b>Background:</b> The advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) marked a significant milestone in the course of cardiac rhythm devices, particularly for patients who are deemed at high risk for ventricular arrhythmias and sudden cardiac death. This extracardiac approach makes the S-ICD an especially valuable option for young patients, those with difficult venous access, or those at high risk of infection. Although the S-ICD does not provide pacing for bradycardia or heart failure, it has shown efficacy in treating ventricular arrhythmias while minimizing complications associated with transvenous systems. <b>Methods</b>: The purpose of this multicenter retrospective analysis was to assess the real-world efficacy and safety of the S-ICD in a heterogeneous population. <b>Results</b>: The GASP registry consisted of 114 patients, 68% male, aged 41 ± 15 years, with a mean LVEF of 50%. In the follow-up of 35 months, inappropriate shocks occurred in 7% while appropriate shocks occurred in 6.2%. The most common reasons for inappropriate shocks were myopotentials and atrial tachyarrhythmias. Thirty-day complication-free rates were 97.3%, with the majority of patients requiring device extraction due to infection. Over the longer term, four patients required re-intervention due to local discomfort, while one device was extracted for infection. In a multivariate analysis, complications were not significantly higher in the sicker population, such as those with diabetes, kidney disease requiring dialysis, or heart failure. <b>Conclusions</b>: These findings support the growing role of the S-ICD as an alternative to the TV-ICD, especially in patients without pacing indications. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| series | Biomedicines |
| spelling | doaj-art-d6ae87e1b4a64c27a79f7a42ed9791752025-08-20T03:36:02ZengMDPI AGBiomedicines2227-90592025-06-01137151010.3390/biomedicines13071510Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP RegistryNikias Milaras0Evangelos Oikonomou1Konstantinos P. Letsas2Nikolaos Ktenopoulos3Sotirios Xydonas4Panagiotis Korantzopoulos5Georgios Leventopoulos6Panagiotis Dourvas7Stefanos Archontakis8Athena Batsouli9Panagiotis Mililis10Athanasios Saplaouras11Emmanuel Kanoupakis12Konstantinos Toutouzas13Stylianos Paraskevaidis14Michalis Efremidis15Skevos Sideris16Cardiology Department, General Hospital of Athens Ippokrateion, Vasilissis Sofias 114, 11527 Athens, GreeceMedical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center Athens, 17674 Athens, GreeceMedical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceSecond Department of Cardiology, Evangelismos General Hospital of Athens, 10676 Athens, GreeceFirst Department of Cardiology, Faculty of Medicine, University of Ioannina, 45110 Ioannina, GreeceDepartment of Cardiology, University Hospital of Patras, 26504 Rion-Patras, GreeceCardiology Department, General Hospital of Athens Ippokrateion, Vasilissis Sofias 114, 11527 Athens, GreeceCardiology Department, General Hospital of Athens Ippokrateion, Vasilissis Sofias 114, 11527 Athens, GreeceSecond Department of Cardiology, Evangelismos General Hospital of Athens, 10676 Athens, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center Athens, 17674 Athens, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center Athens, 17674 Athens, GreeceDepartment of Cardiology, University Hospital of Heraklion, 71500 Crete, GreeceMedical School, National and Kapodistrian University of Athens, 11527 Athens, GreeceFirst Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center Athens, 17674 Athens, GreeceCardiology Department, General Hospital of Athens Ippokrateion, Vasilissis Sofias 114, 11527 Athens, Greece<b>Background:</b> The advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) marked a significant milestone in the course of cardiac rhythm devices, particularly for patients who are deemed at high risk for ventricular arrhythmias and sudden cardiac death. This extracardiac approach makes the S-ICD an especially valuable option for young patients, those with difficult venous access, or those at high risk of infection. Although the S-ICD does not provide pacing for bradycardia or heart failure, it has shown efficacy in treating ventricular arrhythmias while minimizing complications associated with transvenous systems. <b>Methods</b>: The purpose of this multicenter retrospective analysis was to assess the real-world efficacy and safety of the S-ICD in a heterogeneous population. <b>Results</b>: The GASP registry consisted of 114 patients, 68% male, aged 41 ± 15 years, with a mean LVEF of 50%. In the follow-up of 35 months, inappropriate shocks occurred in 7% while appropriate shocks occurred in 6.2%. The most common reasons for inappropriate shocks were myopotentials and atrial tachyarrhythmias. Thirty-day complication-free rates were 97.3%, with the majority of patients requiring device extraction due to infection. Over the longer term, four patients required re-intervention due to local discomfort, while one device was extracted for infection. In a multivariate analysis, complications were not significantly higher in the sicker population, such as those with diabetes, kidney disease requiring dialysis, or heart failure. <b>Conclusions</b>: These findings support the growing role of the S-ICD as an alternative to the TV-ICD, especially in patients without pacing indications.https://www.mdpi.com/2227-9059/13/7/1510S-ICDsubcutaneous ICDsudden deathdefibrillator |
| spellingShingle | Nikias Milaras Evangelos Oikonomou Konstantinos P. Letsas Nikolaos Ktenopoulos Sotirios Xydonas Panagiotis Korantzopoulos Georgios Leventopoulos Panagiotis Dourvas Stefanos Archontakis Athena Batsouli Panagiotis Mililis Athanasios Saplaouras Emmanuel Kanoupakis Konstantinos Toutouzas Stylianos Paraskevaidis Michalis Efremidis Skevos Sideris Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry Biomedicines S-ICD subcutaneous ICD sudden death defibrillator |
| title | Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry |
| title_full | Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry |
| title_fullStr | Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry |
| title_full_unstemmed | Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry |
| title_short | Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry |
| title_sort | real world efficacy and safety of the subcutaneous implantable cardioverter defibrillator insights from the gasp registry |
| topic | S-ICD subcutaneous ICD sudden death defibrillator |
| url | https://www.mdpi.com/2227-9059/13/7/1510 |
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