open access

Vol 76, No 11 (2018)
ORIGINAL ARTICLES
Published online: 2018-08-03
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Factors determining the choice between subcutaneous or transvenous implantable cardioverter-defibrillators in Poland in comparison with other European countries: a sub-study of the European Heart Rhythm Association prospective survey

Ewa Jędrzejczyk-Patej, Serge Boveda, Zbigniew Kalarus, Michał Mazurek, Kinga Gościńska-Bis, Marek Kiliszek, Andrzej Przybylski, Tatjana S. Potpara, Roland Tilz, Stefano Fumagalli, Nikolaos Dagres, Radosław Lenarczyk
DOI: 10.5603/KP.a2018.0155
·
Kardiol Pol 2018;76(11):1507-1515.

open access

Vol 76, No 11 (2018)
ORIGINAL ARTICLES
Published online: 2018-08-03

Abstract

Background: Subcutaneous implantable cardioverter-defibrillator (S-ICD) may be an alternative to transvenous ICD (TV-ICD).

Aim: We sought to evaluate factors determining the choice of S-ICD vs. TV-ICD in Polish patients in comparison to other European countries.

Methods: All consecutive patients who underwent TV-ICD or S-ICD implantation in centres participating in the European Heart Rhythm Association prospective snapshot survey were included.

Results: During an eight-week study period, 429 patients were recruited, including 136 (31.7%) ICD patients from Poland (eight with S-ICD). In comparison to other European centres, the proportion of S-ICD implantations in Poland was lower (7% vs. 26%, p < 0.001), whereas the ratio of cardiac resynchronisation therapy defibrillator implantations was higher (43% vs. 26%; p < 0.001). Subjects receiving S-ICD in Poland were more often over 75 years old (25% vs. 0%, p < 0.001), in New York Heart Association class II (87.5% vs. 29.4%, p = 0.001), with chronic kidney disease (37.5% vs. 5.9%, p = 0.003), and with lower left ventricular ejection fraction (32% [14%–50%] vs. 50% [25%–60%], p = 0.04), compared to other European countries. Additionally, in comparison to subjects from other European centres, Polish patients were significantly more often implanted with S-ICD due to prior infection (37.5% vs. 1.5%, p < 0.001) and a lack of venous access (25% vs. 0%, p < 0.001), whereas the largest subset of patients in other European countries were implanted with S-ICD because of young age (50% vs. 25%, p = NS).

Conclusions: The main reasons leading to S-ICD implantations in Polish patients differ from the indications adopted in other European countries. In Poland, patients referred for TV-ICD or S-ICD implantation had more advanced heart failure and more comorbidities in comparison to subjects from other European countries. S-ICD is still underused in Polish patients.

Abstract

Background: Subcutaneous implantable cardioverter-defibrillator (S-ICD) may be an alternative to transvenous ICD (TV-ICD).

Aim: We sought to evaluate factors determining the choice of S-ICD vs. TV-ICD in Polish patients in comparison to other European countries.

Methods: All consecutive patients who underwent TV-ICD or S-ICD implantation in centres participating in the European Heart Rhythm Association prospective snapshot survey were included.

Results: During an eight-week study period, 429 patients were recruited, including 136 (31.7%) ICD patients from Poland (eight with S-ICD). In comparison to other European centres, the proportion of S-ICD implantations in Poland was lower (7% vs. 26%, p < 0.001), whereas the ratio of cardiac resynchronisation therapy defibrillator implantations was higher (43% vs. 26%; p < 0.001). Subjects receiving S-ICD in Poland were more often over 75 years old (25% vs. 0%, p < 0.001), in New York Heart Association class II (87.5% vs. 29.4%, p = 0.001), with chronic kidney disease (37.5% vs. 5.9%, p = 0.003), and with lower left ventricular ejection fraction (32% [14%–50%] vs. 50% [25%–60%], p = 0.04), compared to other European countries. Additionally, in comparison to subjects from other European centres, Polish patients were significantly more often implanted with S-ICD due to prior infection (37.5% vs. 1.5%, p < 0.001) and a lack of venous access (25% vs. 0%, p < 0.001), whereas the largest subset of patients in other European countries were implanted with S-ICD because of young age (50% vs. 25%, p = NS).

Conclusions: The main reasons leading to S-ICD implantations in Polish patients differ from the indications adopted in other European countries. In Poland, patients referred for TV-ICD or S-ICD implantation had more advanced heart failure and more comorbidities in comparison to subjects from other European countries. S-ICD is still underused in Polish patients.

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Keywords

subcutaneous implantable cardioverter-defibrillator; sudden cardiac death; ventricular tachyarrhythmias

About this article
Title

Factors determining the choice between subcutaneous or transvenous implantable cardioverter-defibrillators in Poland in comparison with other European countries: a sub-study of the European Heart Rhythm Association prospective survey

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 11 (2018)

Pages

1507-1515

Published online

2018-08-03

DOI

10.5603/KP.a2018.0155

Bibliographic record

Kardiol Pol 2018;76(11):1507-1515.

Keywords

subcutaneous implantable cardioverter-defibrillator
sudden cardiac death
ventricular tachyarrhythmias

Authors

Ewa Jędrzejczyk-Patej
Serge Boveda
Zbigniew Kalarus
Michał Mazurek
Kinga Gościńska-Bis
Marek Kiliszek
Andrzej Przybylski
Tatjana S. Potpara
Roland Tilz
Stefano Fumagalli
Nikolaos Dagres
Radosław Lenarczyk

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