ArticleEuropean heart journal2022
Subcutaneous implantable cardioverter-defibrillators: long-term results of the EFFORTLESS study.
Article in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 95 citations in OpenAlex.
- Device-related complications in subcutaneous versus transvenous ICD: a secondary analysis of the PRAETORIAN trial.European heart journal · 2022Trial
- Similarities and Differences Between the Extravascular and the Subcutaneous Implantable Cardioverter-Defibrillator: Clinical Selection and Implantation (Part 1).Current cardiology reports · 2026Review
- Innovations in cardiac device therapy in the era of advanced rhythm management: implantable defibrillators and conduction system pacing.Heart (British Cardiac Society) · 2026Review
- Isolated extravascular implantable cardioverter-defibrillator infection without leadless pacemaker involvement: A unique dual-device case report.HeartRhythm case reports · 2026Article
- Efficacy and safety of the subcutaneous implantable cardioverter defibrillator in patients with and without obesity: An international, bicentric retrospective registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- The HONEST Cohort Study: Rationale and Design of a Nationwide Subcutaneous Implantable Cardioverter-Defibrillator Cohort.JACC. Advances · 2026Article
- [Subcutaneous defibrillator (S-ICD)].Herz · 2025Article
- A review of the extravascular implantable cardioverter-defibrillator system: technology, development, clinical outcomes, and global experience.Herzschrittmachertherapie & Elektrophysiologie · 2025Review
- Review
- Is Septal Pacing Effective for Antitachycardia Pacing of Implantable Cardioverter-Defibrillator?JACC. Asia · 2025Article
- Antithrombotic therapy and the risk of pocket hematoma after subcutaneous implantable cardioverter-defibrillator implantation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Intermuscular two-incision technique for implantation of the subcutaneous implantable cardioverter defibrillator: a 3-year follow-up.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Real-World Efficacy and Safety of the Subcutaneous Implantable Cardioverter Defibrillator: Insights from the GASP Registry.Biomedicines · 2025Article
- Subcutaneous cardioverter defibrillator implanted intermuscularly in patients with end-stage renal disease requiring hemodialysis: 5-year follow-up.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Simultaneous subcutaneous implantable cardioverter-defibrillator and leadless pacemaker implantation for patients at high risk of infection: a retrospective case series report.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Review
- One heart, seven leads: A case report of complex cardiac device therapy in a patient with chemotherapy-induced toxic cardiomyopathy.HeartRhythm case reports · 2025Article
- Long-term safety and efficacy of subcutaneous implantable cardioverter-defibrillator compared with transvenous implantable cardioverter-defibrillator in propensity score-matched patients from Japan.Journal of arrhythmia · 2025Article
- Long-Term Follow-Up of the S-ICD: A 10-Years Follow-Up Study of a Large Single Center Cohort.Pacing and clinical electrophysiology : PACE · 2025Article
- Long-Term Complications Related to Cardiac Implantable Electronic Devices.Journal of clinical medicine · 2025Review
- Rates of and Indications for Subcutaneous ICD Extraction: A Multihospital Healthcare System Analysis.Journal of cardiovascular electrophysiology · 2025Article
Corrections and comments
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Authors and funding
14 authors at 12 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo report 5-year outcomes of EFFORTLESS registry patients with early generation subcutaneous implantable cardioverter-defibrillator (S-ICD) devices. METHODS AND
resultsKaplan-Meier, trend and multivariable analyses were performed for mortality and late (years 2-5) complications, appropriate shock (AS) and inappropriate shock (IAS) rates. Nine hundred and eighty-four of 994 enrolled patients with diverse diagnoses (28% female, 48 ± 17 years, body mass index 27 ± 6 kg/m2, ejection fraction 43 ± 18%) underwent S-ICD implantation. Median follow-up was 5.1 years (interquartile range 4.7-5.5 years). All-cause mortality was 9.3% (95% confidence interval 7.2-11.3%) at 5 years; 703 patients remained in follow-up on study completion, 171 withdrew including 87 (8.8%) with device explanted, and 65 (6.6%) lost to follow-up. Of the explants, only 20 (2.0%) patients needed a transvenous device for pacing indications. First and final shock efficacy for discrete ventricular arrhythmias was consistent at 90% and 98%, respectively, with storm episode final shock efficacy at 95.2%. Time to therapy remained unaltered. Overall 1- and 5-year complication rates were 8.9% and 15.2%, respectively. Early complications did not predict later complications. There were no structural lead failures. Inappropriate shock rates at 1 and 5 years were 8.7% and 16.9%, respectively. Self-terminating inappropriately sensed episodes predicted late IAS. Predictors of late AS included self-terminating appropriately sensed episodes and earlier AS.
conclusionIn this diverse S-ICD registry population, spontaneous shock efficacy was consistently high over 5 years. Very few patients underwent S-ICD replacement with a transvenous device for pacing indications. Treated and self-terminating arrhythmic episodes predict future shock events, which should encourage more personalized device optimization.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.