Journal of cardiovascular electrophysiology · 2026
Different Effects of Defibrillator Shocks on the Myocardial Damage Between Subcutaneous and Transvenous Implantable Cardioverter-Defibrillators.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Kadosaka Takahide, Watanabe Masaya, Nakao Motoki, Koya Taro, Hagiwara Hikaru, Gibo Hiroyuki, Temma Taro, Mizukami Kazuya, Yokoshiki Hisashi, Anzai Toshihisa
Аннотация
BACKGROUND: Although the implantable cardioverter defibrillators (ICD) are the only established treatment to prevent sudden cardiac death, previous studies reported that those who receive shock therapies, whether appropriate or inappropriate, have a higher risk of death. However, the difference in the influence of shock therapies between via Transvenous-ICD (TV-ICD) and Subcutaneous-ICD (S-ICD) has not been adequately examined. We aimed to investigate the influence of shocks on myocardium in patients with TV-ICD and S-ICD.
METHODS: We enrolled consecutive patients who received a defibrillator or transvenous pacemaker (TV-PM) implantation between November 2020 and March 2024. A total of 74 patients were included in this study and divided into three groups: patients with TV-ICD with defibrillation testing (DFT) (TV-DFT, 27 patients), those with transvenous devices implanted without DFT (TV-no DFT, 25 patients) and those with S-ICD (22 patients).
RESULTS: Delta log troponin-I (the difference of serum troponin-I levels between baseline and after implantation) was significantly increased in TV-DFT group. In patients with TV-ICD (46 patients), Delta log troponin-I was significantly correlated with total shock joules. In the multivariable linear regression analysis, a value of total shock joules was independently associated with delta troponin-I.
CONCLUSION: Elevation of serum troponin-I was associated with the TV-ICD shocks and correlated with the total shock energy, but not with S-ICD shocks. Our results suggest that TV-ICD shocks are associated with greater myocardial injury compared to S-ICD shocks, and that total shock energy is an important determinant of the extent of myocardial damage.
METHODS: We enrolled consecutive patients who received a defibrillator or transvenous pacemaker (TV-PM) implantation between November 2020 and March 2024. A total of 74 patients were included in this study and divided into three groups: patients with TV-ICD with defibrillation testing (DFT) (TV-DFT, 27 patients), those with transvenous devices implanted without DFT (TV-no DFT, 25 patients) and those with S-ICD (22 patients).
RESULTS: Delta log troponin-I (the difference of serum troponin-I levels between baseline and after implantation) was significantly increased in TV-DFT group. In patients with TV-ICD (46 patients), Delta log troponin-I was significantly correlated with total shock joules. In the multivariable linear regression analysis, a value of total shock joules was independently associated with delta troponin-I.
CONCLUSION: Elevation of serum troponin-I was associated with the TV-ICD shocks and correlated with the total shock energy, but not with S-ICD shocks. Our results suggest that TV-ICD shocks are associated with greater myocardial injury compared to S-ICD shocks, and that total shock energy is an important determinant of the extent of myocardial damage.