ArticleJournal of cardiovascular electrophysiology2025
Elective Generator Replacement of the Subcutaneous Implantable Defibrillator-Always a Simple Pit Stop?
Article in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
1 citing paper in PubMed.
- [Subcutaneous defibrillator (S-ICD)].Herz · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
BACKGROUND AND
aimsThe safety and efficacy of the subcutaneous implantable cardioverter-defibrillator (S-ICD) has been proven in various clinical trials. Data on device replacement strategies is scarce. This study aims to evaluate long-term shock efficacy, trends in shock impedance, and the effects of a replacement strategy at elective device replacement.
methodsBetween January 2018 and November 2022, a total of 99 consecutive patients underwent S-ICD device replacement. Shock impedance was determined at initial implantation, before and after device replacement. In case of high shock impedance, additional optimization of lead and generator position was performed if applicable, as well as the removal of fibrous encapsulation ("capsulectomy") of the S-ICD pocket.
resultsDefibrillation testing with the first 65 J shock was successful in 87% of patients after initial device implantation versus 85% with the same device immediately before device replacement (p = 0.88). Eight patients preoperatively failed defibrillation testing with 65 J and 80 J. After a mean dwell time of 65 ± 21 months, shock impedance increased significantly from 82 ± 23 Ω at initial implantation to 98 ± 37 Ω at replacement (p = 0.004). Capsulectomy and optimized repositioning of the S-ICD lead and generator resulted in a significant decrease of shock impedance to 81 ± 25 Ω as compared to 98 ± 37 Ω before the replacement (p = 0.004). 65 J shock efficacy improved to 95%. Postoperative defibrillation testing was successful in all patients. No acute complications were observed.
conclusionHigh conversion rates at device replacement are achievable through optimized replacement strategy. In addition to improving the lead and generator position, capsulectomy appears to be a safe and effective way to reduce shock impedance and might contribute to overall system performance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.