Acute shock efficacy of the subcutaneous implantable cardioverter‐defibrillator according to the implantation technique

BACKGROUND The traditional technique for subcutaneous implantable cardioverter defibrillator (S-ICD) implantation involves three incisions and a (SC) pocket. An intermuscular (IM) 2-incision has been recently adopted. AIMS We assessed acute defibrillation efficacy (DE) of S-ICD (DE ≤65 J) according to the technique. METHODS analyzed consecutive patients who underwent DE testing at 53 Italian centers. Regression analysis was used determine association between DFT RESULTS A total 805 were enrolled. Four groups assessed: IM + 2 (n = 546), SC + 2 (n = 133), SC + 3 (n = 111), IM + 3 (n = 15). ≤65 J in 782 (97.1%) patients. Patients with DE ≤65 J showed trend towards lower body mass index (25.1 vs. 26.5; p = .12), less frequently on antiarrhythmic drugs (13% 26%; p = .06) more commonly (85% 70%; p = .04). IM + 2-incision lowest failure rate (2.2%) shock impedance (66 Ohm, interquartile range: 57-77). On multivariate analysis, associated incidence (hazard ratio: 0.305; 95% confidence interval: 0.102-0.907; p = .033). Shock IM than SC approach (66 70 Ohm p = .002) 3-incision (67 72 Ohm; p = .006). CONCLUSIONS In large population patients, we observed high success rate. provides higher likelihood successful defibrillation.