Sistemas Lineales Análisis de error Prof.: Dra. Nélida Beatriz Brignole.
Michele Brignole Centro Aritmologico - Lavagna Brignole.pdf · Il defibrillatore sottocutaneo...
Transcript of Michele Brignole Centro Aritmologico - Lavagna Brignole.pdf · Il defibrillatore sottocutaneo...
Indicazione certa
Difficoltà ad impianto di
catetere endocardico
Indicazione possibile
In alternativa a ICD
transvenoso quando non è
richiesto pacing
Controindicazione
Quando è richiesto pacing
Il defibrillatore sottocutaneo (S-ICD)
Quando una nuova terapia diventa acquisita (“established”) ?
Quando è dimostrato che il beneficio della nuova terapia
è superiore a quello della terapia convenzionale
Major in-hospital complications among Medicare beneficiaries receiving
ICD/CRT
M Reynolds et al. J Am Coll Cardiol 2006; 47: 2493–2497
Defibrillation Lead Defects in ICDs over a period of >10 years
Kleemann T et al. Circulation 2007; 115: 2474-80
Complications and reoperations after ICD-CRT implantation
among 114.488 US patients
Ann Intern Med 2016
Complications and reoperations after ICD-CRT implantation
among 114.488 US patients
Ann Intern Med 2016
Results from most recent multicenter American and European registries
Total 4.1% 4.1%
23. JACC 2015; 65: 1605 24. Eur Heart J 2014; 35: 1657
Complications and reoperations after ICD-CRT implantation
among 114.488 US patients
Ann Intern Med 2016
S-ICD
follow-up time
Lewis et al. J Am Coll Cardiol 2016; 67: 445-454
A Comparison of Safety and Efficacy of the S-ICD With Transvenous ICD
Lewis et al. J Am Coll Cardiol 2016; 67: 445-454
A Comparison of Safety and Efficacy of the S-ICD With Transvenous ICD
Conclusion
There is evidence (in the absence of randomized trials)
suggesting its non-inferiority to traditional ICD
systems with regard to safety and efficacy