Personalized screening before subcutaneous cardioverter-defibrillator implantation: Usefulness and outcomes in clinical practice—the S-ICD screening SIS prospective study - Université de Rennes
Article Dans Une Revue Heart Rhythm Année : 2024

Personalized screening before subcutaneous cardioverter-defibrillator implantation: Usefulness and outcomes in clinical practice—the S-ICD screening SIS prospective study

1 Centre hospitalier de Pau
2 Service de cardiologie [CHU de Poitiers]
3 CIC 1402 - CIC Poitiers – Centre d'investigation clinique de Poitiers
4 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
5 ITX-lab - ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291
6 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
7 HEGP - Hôpital Européen Georges Pompidou [APHP]
8 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
9 UBO - Université de Brest
10 UCL - Université catholique de Lille
11 Hôpital Saint Philibert [Lomme]
12 UNICAEN Santé - Université de Caen Normandie - UFR Santé
13 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
14 Université de Lille
15 UNILIM - Université de Limoges
16 CHU Limoges
17 Service Cardiologie [CHU Toulouse]
18 Hôpital Louis Pradel [CHU - HCL]
19 UCBL - Université Claude Bernard Lyon 1
20 CHU Pitié-Salpêtrière [AP-HP]
21 LTSI - Laboratoire Traitement du Signal et de l'Image
22 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
23 NanoRegMed - Nanomédecine Régénérative
24 CRBS - Centre de Recherche en Biomédecine de Strasbourg
25 Nouvel Hôpital Civil de Strasbourg
26 CHU Trousseau [Tours]
27 CHU Henri Mondor [Créteil]
28 TIMONE - Hôpital de la Timone [CHU - APHM]
29 AMU - Aix Marseille Université
30 CH Alpes Isere - Centre Hospitalier Alpes Isère [Grenoble, France]
31 CHU Rouen
32 Clinique Pasteur [Toulouse]
Frédéric Anselme
  • Fonction : Auteur

Résumé

Background: Electrocardiographic screening before subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is unsuccessful in around 10% of cases. A personalized screening method, by slightly moving the electrodes, to obtain a better R/T ratio has been described to overcome traditional screening failure.
Objective: The objectives of the SIS study were to assess to what extent a personalized screening method improves eligibility for S-ICD implantation and to evaluate the inappropriate shock rate after such screening success.
Methods: All consecutive patients eligible for an S-ICD implantation were prospectively recruited across 20 French centers between December 2019 and January 2022. In case of traditional screening failure, patients received a second personalized screening. If at least 1 vector was positive, the personalized screening was considered successful, and the patient was eligible for implantation.
Results: The study included 474 patients (mean age, 50.4 ± 14.1 years; 77.4% men). Traditional screening was successful in 456 (96.2%) cases. This figure rose to 98.3% (n = 466; P = .002) when personalized screening was performed. All patients implanted after successful personalized screening had correct signal detection on initial device interrogation. Nevertheless, after 1-year follow-up, 3 of the 7 patients (43%) implanted with personalized screening experienced inappropriate shock vs 18 of the 427 patients (4.2%) with traditional screening and S-ICD implantation (P = .003).
Conclusion: Traditional S-ICD screening was successful in our study in a high proportion of patients. Considering the small improvement in success of screening and a higher rate of inappropriate shock, a strategy of personalized screening cannot be routinely recommended.
Clinicaltrials: gov identifier: NCT04101253
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hal-04811313 , version 1 (09-12-2024)

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Maxime de Guillebon, Rodrigue Garcia, Stéphane Debeugny, Hugues Bader, Vincent Probst, et al.. Personalized screening before subcutaneous cardioverter-defibrillator implantation: Usefulness and outcomes in clinical practice—the S-ICD screening SIS prospective study. Heart Rhythm, 2024, 21 (12), pp.2530-2535. ⟨10.1016/j.hrthm.2024.05.043⟩. ⟨hal-04811313⟩
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