TY - JOUR T1 - Efficacy and safety of the subcutaneous implantable cardioverter defibrillator: a systematic review JF - Heart JO - Heart SP - 1315 LP - 1322 DO - 10.1136/heartjnl-2016-310852 VL - 103 IS - 17 AU - Colin Dominic Chue AU - Chun Shing Kwok AU - Chun Wai Wong AU - Ashish Patwala AU - Diane Barker AU - Amir Zaidi AU - Mamas A Mamas AU - Colin Cunnington AU - Fozia Z Ahmed Y1 - 2017/09/01 UR - http://heart.bmj.com/content/103/17/1315.abstract N2 - Background Subcutaneous implantable cardioverter defibrillators (S-ICDs) are considered an alternative to conventional transvenous ICDs (TV-ICDs) in patients not requiring pacing.Methods We searched MEDLINE and EMBASE for studies evaluating efficacy and safety outcomes in S-ICD patients. Outcomes were pooled across studies.Results Sixteen studies were included with 5380 participants (mean age range 33–56 years). Short-term follow-up data were available for 1670 subjects. The most common complication was pocket infection, affecting 2.7%. Other complications included delayed wound healing (0.6%) and wound discomfort (0.8%). 3.8% of S-ICDs were explanted, most commonly for pocket infection. Mortality rates in hospital (0.4%) and during follow-up (3.4% from 12 studies reporting) were low. Incidence of ventricular arrhythmia varied from 0% to 12%. Overall shock efficacy exceeded 96%. Inappropriate shocks affected 4.3% and was most commonly caused by T-wave oversensing.Conclusions Although long-term randomised data are lacking, observational data suggest similar shock efficacy and short-term complication rates between the S-ICD and TV-ICD. ER -