Subcutaneous implantable cardioverter-defibrillator generator removal: a multicenter analysis

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): University Hospital Cologne Introduction The subcutaneous implantable cardioverter-defibrillator (S-ICD) was a significant recent advance in sudden cardiac death prevention. Device-related complications, including infection or lead fracture, or changes in the medical status, such as necessity for cardiac pacing, may necessitate device removal. (1) Real-world multicenter data on S-ICD removal are sparse. Purpose This multicenter analysis sought to assess the incidence and indications for S-ICD generator removal. Methods Retrospective data and the most recent follow-up data on S-ICD devices implanted at 14 participating centers in Europe, the US and Canada, and information on subsequent device removal was submitted to an online database (2). Limited baseline patient information and the incidence of and reasons for S-ICD generator removal or failure were reported. Premature device removal was defined as device removal for any reason other than regular battery depletion (>5 years of longevity). Results Data from 1106 devices was analyzed. Devices were implanted between 15.10.2009 and 16.04.2021 at the participating centers. The first-generation model 1010 generator was implanted in 55 (5%), the newer models A209 or A219 were implanted in 457 (41.3%) and 594 (53.7%) respectively. Patients were aged 46.7±16.1 years and the indication for ICD therapy was primary prevention in 616 (55.7%) and secondary prevention in 484 (43.8%). During the follow-up period, 37 (3%) patients deceased, and 96 patients were excluded from the analysis due to lack of follow-up (