DOI: 10.1161/circ.148.suppl_1.17080 ISSN: 0009-7322

Abstract 17080: Subcutaneous Implantable Cardioverter Defibrillator in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis

Vinicius M Oliveira, Izadora C Oliveira, Antonio da Silva Menezes Junior
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an alternative to transvenous implantable cardioverter-defibrillator (TV-ICD), mitigating the risks associated with transvenous leads. However, the effects of S-ICD in hypertrophic cardiomyopathy (HCM) remains uncertain. Thus, we performed a systematic review and meta-analysis to assess the efficacy and safety of S-ICD in treating patients with HCM.

Methods: We systematically searched PubMed, Embase and Scopus on April 2023 for studies comparing S-ICD to TV-ICD in patients with HCM. Key endpoints of interest included incidence of appropriate shocks (AS), inappropriate shocks (IAS), and device-related complications. Odds ratios (ORs) and their 95% confidence intervals (CIs) were computed using a random-effects model. Heterogeneity was assessed with I 2 statistics, and a p-value of <0.05 was considered statistically significant.

Results: We screened 1070 records. Six studies comprising 3,820 patients were included, of whom 2,497 (65.4%) were male. Mean age ranged from 39.1 to 49.4 years. Our pooled analysis indicated that device-related complications were significantly less frequent in the S-ICD group compared with the TV-ICD group (OR 0.39; 95% CI 0.18 to 0.82; p=0.01; Figure 1A). However, the incidences of AS (OR 0.56; 95% CI 0.20-1.57; p=0.27) and IAS (OR 1.26; 95% CI 0.61 to 2.59; p=0.54; Figure 1B) were not significantly different between the two groups.

Conclusions: These findings suggest that S-ICD are associated with fewer device-related complications as compared with TV-ICD, among patients with HCM. Appropriate and inappropriate shocks are not significantly different between the two strategies.

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