| Title: |
Inappropriate Therapy and Shock Rates Between the Subcutaneous and Transvenous Implantable Cardiac Defibrillator: A Secondary Analysis of the PRAETORIAN Trial. |
| Authors: |
Olde Nordkamp, LRA; Pepplinkhuizen, S; Ghani, A; Boersma, LVA; Kuschyk, J; El-Chami, MF; Behr, ER; Brouwer, TF; Kääb, S; Mittal, S; Quast, A-FBE; van der Stuijt, W; Smeding, L; de Veld, JA; Tijssen, JGP; Bijsterveld, NR; Richter, S; Brouwer, MA; de Groot, JR; Kooiman, KM; Lambiase, PD; Neuzil, P; Vernooy, K; Alings, M; Betts, TR; Bracke, FALE; Burke, MC; de Jong, JSSG; Wright, DJ; Jansen, WPJ; Whinnett, ZI; Nordbeck, P; Knaut, M; Philbert, BT; van Opstal, JM; Chicos, AB; Allaart, CP; Borger van der Burg, AE; Dizon, JM; Miller, MA; Nemirovsky, D; Surber, R; Upadhyay, GA; Weiss, R; de Weger, A; Wilde, AAM; Knops, RE; PRAETORIAN Investigators |
| Publisher Information: |
American Heart Association |
| Publication Year: |
2024 |
| Collection: |
St George's University of London: Repository |
| Description: |
BACKGROUND: Inappropriate therapy (IAT) is an undesirable side effect of implantable cardiac defibrillator (ICD) therapy. Early studies with the subcutaneous ICD (S-ICD) showed relatively high inappropriate shock (IAS) rates. The PRAETORIAN (Prospective Randomized Comparison of Subcutaneous and Transvenous Implantable Cardioverter Defibrillator Therapy) trial demonstrated that the S-ICD is noninferior to the transvenous ICD (TV-ICD) with regard to the combined end point of IAS and complications. This secondary analyses evaluates all IAT in the PRAETORIAN trial. METHODS: This international, multicenter trial randomized 849 patients with an indication for ICD therapy between S-ICD (n=426) and TV-ICD therapy (n=423). ICD programming was mandated by protocol. All analysis were performed in the modified intention-to-treat population. RESULTS: In both groups 42 patients experienced IAT (48-month Kaplan-Meier estimated cumulative incidence, 9.9% and 10.1%, respectively; hazard ratio (HR), 0.99 [95% CI, 0.65-1.52]; P=0.97). There was no significant difference in patients experiencing IAS between both groups (P=0.14). In the S-ICD group, 81 IAT episodes with 124 IAS and 1 inappropriate antitachycardia pacing occurred versus 89 IAT episodes with 130 IAS and 124 inappropriate antitachycardia pacing in the TV-ICD group. IAT episodes were most frequently caused by supraventricular tachycardias in the TV-ICD group (n=83/89) versus cardiac oversensing in the S-ICD group (n=40/81). In the TV-ICD group, a baseline heart rate >80 bpm (HR, 1.99 [95% CI, 1.05-3.76]; P=0.03), a history of atrial fibrillation (HR, 2.66 [95% CI, 1.41-5.02]; P=0.003), and smoking (HR, 2.46 [95% CI, 1.31-4.09]; P=0.005) were independent predictors for IAT. A QRS duration >120 ms was an independent predictor for IAT caused by cardiac oversensing in the S-ICD group (HR, 3.13 [95% CI, 1.34-7.31]; P=0.008). Post-IAS interventions significantly reduced IAS recurrence in both groups (P=0.046). CONCLUSIONS: There was no significant difference in IAT and ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
1941-3084 |
| Relation: |
https://openaccess.sgul.ac.uk/id/eprint/116988/1/olde-nordkamp-et-al-2024-inappropriate-therapy-and-shock-rates-between-the-subcutaneous-and-transvenous-implantable.pdf; https://openaccess.sgul.ac.uk/id/eprint/116988/6/circae-2024-012836-t-s01.pdf; Olde Nordkamp, LRA; Pepplinkhuizen, S; Ghani, A; Boersma, LVA; Kuschyk, J; El-Chami, MF; Behr, ER; Brouwer, TF; Kääb, S; Mittal, S; et al. Olde Nordkamp, LRA; Pepplinkhuizen, S; Ghani, A; Boersma, LVA; Kuschyk, J; El-Chami, MF; Behr, ER; Brouwer, TF; Kääb, S; Mittal, S; Quast, A-FBE; van der Stuijt, W; Smeding, L; de Veld, JA; Tijssen, JGP; Bijsterveld, NR; Richter, S; Brouwer, MA; de Groot, JR; Kooiman, KM; Lambiase, PD; Neuzil, P; Vernooy, K; Alings, M; Betts, TR; Bracke, FALE; Burke, MC; de Jong, JSSG; Wright, DJ; Jansen, WPJ; Whinnett, ZI; Nordbeck, P; Knaut, M; Philbert, BT; van Opstal, JM; Chicos, AB; Allaart, CP; Borger van der Burg, AE; Dizon, JM; Miller, MA; Nemirovsky, D; Surber, R; Upadhyay, GA; Weiss, R; de Weger, A; Wilde, AAM; Knops, RE; PRAETORIAN Investigators (2024) Inappropriate Therapy and Shock Rates Between the Subcutaneous and Transvenous Implantable Cardiac Defibrillator: A Secondary Analysis of the PRAETORIAN Trial. Circ Arrhythm Electrophysiol, 17 (12). e012836. ISSN 1941-3084 https://doi.org/10.1161/CIRCEP.124.012836 SGUL Authors: Behr, Elijah Raphael |
| DOI: |
10.1161/CIRCEP.124.012836 |
| Availability: |
https://openaccess.sgul.ac.uk/id/eprint/116988/; https://doi.org/10.1161/CIRCEP.124.012836 |
| Rights: |
cc_by_nc_nd_4 |
| Accession Number: |
edsbas.319C4F0A |
| Database: |
BASE |