Highlights
- •Thirty-six articles and 2750 patients with arrhythmia syndromes were reviewed.
- •About 2/3 of the ICDs were implanted in secondary prevention of sudden death.
- •The rate of appropriate and inappropriate therapies was 21% and 20%, respectively.
- •Lead malfunction was the most common non-shock ICD-related complication.
Abstract
Background
The potential benefit of implantable cardioverter-defibrillator (ICD) therapy in individuals
with inherited arrhythmia syndromes is well known. However, it is not deprived of
morbidity, in the form of inappropriate therapies and other ICD-related complications.
Objective
The aim of this systematic review is to estimate the rate of appropriate and inappropriate
therapy, as well as other ICD-related complications, in individuals with inherited
arrhythmia syndromes.
Methods
A systematic review was performed, regarding appropriate and inappropriate therapy,
and other ICD-related complications, in individuals with inherited arrhythmia syndromes
(Brugada Syndrome, Catecholaminergic Polymorphic Ventricular Tachycardia, Early Repolarization
Syndrome, Long QT Syndrome and Short QT syndrome). Studies were identified by searching
published papers in PubMed and Embase up to August 23rd, 2022.
Results
From data gathered of 36 studies, with a total of 2750 individuals, during a mean
follow-up time of 69 months, appropriate therapies occurred in 21% of the individuals
and inappropriate therapies in 20% of the individuals. Concerning the other ICD-related
complications, 456 complications were observed, amongst 2084 individuals (22%), with
the most frequent being lead malfunction (46%), followed by infectious complications
(13%).
Conclusions
ICD-related complications are not uncommon, especially when one considers the exposure
time of young individuals. The incidence of inappropriate therapies was 20%, although
lower rates were reported in recent publications. S-ICD is an effective alternative
to transvenous ICD for sudden death prevention. The decision to implant an ICD should
be individualized, taking into account the risk profile of each patient, as well as
the possibility of complications.
Keywords
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Article info
Publication history
Published online: February 28, 2023
Accepted:
February 13,
2023
Received in revised form:
February 12,
2023
Received:
October 26,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
