Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease.
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Waldmann Victor, Marquié Christelle, Bessière Francis, Perrot David, Anselme Frédéric, Badenco Nicolas, Barra Sergio, Bertaux Géraldine, Blangy Hugues, Bordachar Pierre, Boveda Serge, Chauvin Michel, Clémenty Nicolas, Clerici Gaël, Combes Nicolas, Defaye Pascal, Deharo Jean-Claude, Durand Philippe, Duthoit Guillaume, Eschalier Romain, Fauchier Laurent, Garcia Rodrigue, Geoffroy Olivier, Gitenay Edouard, Gourraud Jean-Baptiste, Guenancia Charles, Iserin Laurence, Jacon Peggy, Jesel-Morel Laurence, Kerkouri Fawzi, Klug Didier, Koutbi Linda, Labombarda Fabien, Ladouceur Magalie, Laurent Gabriel, Leclercq Christophe, Maille Baptiste, Maltret Alice, Massoulié Grégoire, Mondoly Pierre, Ninni Sandro, Ollitrault Pierre, Pasquié Jean-Luc, Pierre Bertrand, Pujadas Pénélope, Champ-Rigot Laure, Sacher Frédéric, Sadoul Nicolas, Schatz Alexandre, Winum Pierre, Milliez Paul-Ursmar, Probst Vincent, Marijon Eloi, HONEST Investigators
Аннотация
OBJECTIVES: The aim of this study was to analyze outcomes associated with S-ICDs in patients with CHD.
METHODS: This nationwide French cohort including all patients with an S-ICD was initiated in 2020 by the French Institute of Health and Medical Research. Characteristics at implantation and outcomes were analyzed in patients with CHD.
RESULTS: From October 12, 2012, to December 31, 2019, among 4,924 patients receiving an S-ICD implant in 150 centers, 101 (2.1%) had CHD. Tetralogy of Fallot, univentricular heart, and dextro-transposition of the great arteries represented almost one-half of the population. Patients with CHD were significantly younger (age 37.1 ± 15.4 years vs 50.1 ± 14.9 years; P < 0.001), more frequently female (37.6% vs 23.0%; P < 0.001), more likely to receive an S-ICD for secondary prevention (72.3% vs 35.9%; P < 0.001), and less likely to have severe systolic dysfunction of the systemic ventricle (28.1% vs 53.1%; P < 0.001). Over a mean follow-up period of 1.9 years, 16 (15.8%) patients with CHD received at least 1 appropriate shock, with all shocks successfully terminating the ventricular arrhythmia. The crude risk of appropriate S-ICD shock was twice as high in patients with CHD compared with non-CHD patients (annual incidences of 9.0% vs 4.4%; HR: 2.1; 95% CI: 1.3-3.4); however, this association was no longer significant after propensity matching (especially considering S-ICD indication, P = 0.12). The burden of all complications (HR: 1.2; 95% CI: 0.7-2.1; P = 0.4) and inappropriate shocks (HR: 0.9; 95% CI: 0.4-2.0; P = 0.9) was comparable in both groups.
CONCLUSIONS: In this nationwide study, patients with CHD represented 2% of all S-ICD implantations. Our findings emphasize the effectiveness and safety of S-ICD in this particularly high-risk population. (S-ICD French Cohort Study [HONEST]; NCT05302115).