HealthDay News — Subcutaneous implantable defibrillators (S-ICDs) reduce the risk of lead-related complications by more than 90%, according to a study presented at the annual meeting of the Heart Rhythm Society, held from April 29 to May 1 in San Francisco.

Jeff Healey, M.D., from the Population Health Research Institute at McMaster University in Hamilton, Canada, and colleagues randomly assigned ICD-eligible patients (<60 years old), with a cardiogenetic syndrome or at high risk for lead-related complications, to an S-ICD (251 patients) or transvenous (TV)-ICD (252 patients). Major lead-related complications occurring within six months of implantation were compared between the groups.

The researchers found that major lead complications occurred in one patient (0.4%) with S-ICD versus 12 (4.8%) with TV-ICD (odds ratio, 0.08; 95% confidence interval, 0.00 to 0.55; P = 0.003). While not a significant difference, there was a trend toward more inappropriate shocks with S-ICD versus TV-ICD (6.4 versus 2.8%; odds ratio, 2.38; 95% confidence interval, 0.96 to 5.90) and failed appropriate clinical shocks (3.2 versus 2.0%). There was no significant difference seen in sudden death between the groups (0.8 and 1.2%, respectively).

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“The S-ICD greatly reduces perioperative, lead-related complications without significantly compromising ICD performance,” Healey said in a statement. “The S-ICD is now an attractive alternative to the TV-ICD, particularly in patients at increased risk for lead-related complications.”

The study was funded by Boston Scientific.

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