Portal de Periódicos da CAPES

Subcutaneous versus transvenous implantable cardioverter defibrillators in children and young adults: A meta‐analysis

2022; Wiley; Volume: 45; Issue: 12 Linguagem: Inglês

10.1111/pace.14603

1540-8159

Giampaolo Vetta, Antonio Parlavecchio, Michele Magnocavallo, Debora Valente, Rodolfo Caminiti, Marco Polselli, Francesco Vetta, Donatello Cirone, Filippo Maria Cauti, Pasquale Crea, Pietro Rossi, Gian‐Battista Chierchia, Stefano Bianchi, Carlo de Asmundis, Andrea Natale, Domenico G. Della Rocca,

Cardiac electrophysiology and arrhythmias

The implantable cardioverter defibrillator (ICD) has been demonstrated to successfully prevent sudden cardiac death (SCD) in children and young adults. A wide range of device-related complications/malfunctions have been described, which depend on the intrinsic design of the defibrillation system (transvenous-implantable cardioverter defibrillator [TV-ICD] vs. subcutaneous-implantable cardioverter defibrillator [S-ICD]).To compare the device-related complications and inappropriate shocks with TV-ICD versus S-ICD.Electronic databases were queried for studies focusing on the prevention of SCD in children and young adults with TV-ICD or S-ICD. The effect size was estimated using a random-effect model as odds ratio (OR) and relative 95% confidence interval (CI). The primary endpoint was a composite of any device-related complications and inappropriate shocks. We identified a total of five studies including 236 patients (Group S-ICD: 76 patients; Group TV-ICD: 160 patients) with a mean follow-up time of 54.2 ± 24.9 months. S-ICD implantation contributed to a significant reduction in the risk of the primary endpoint of any device-related complications and inappropriate shocks (OR: 0.18; 95% CI: 0.05-0.73; p = .02). S-ICD was also associated with a significantly lower incidence of inappropriate shocks (OR: 0.28; 95% CI: 0.11-0.74; p = .01) and lead-related complications (OR: 0.18; 95% CI: 0.05-0.66; p = .01). A trend toward a higher risk of pocket complications (OR: 5.91; 95% CI: 0.98-35.63; p = .05) was recorded in patients with S-ICD.Children and young adults undergoing S-ICD implantation may have a lower risk of a composite of device-related complications and inappropriate shocks, compared to TV-ICD patients.