Latest implantable defibrillator: Focus on the S-ICD

Forty percent of sudden cardiac deaths occur in patients with known risk factors e.g., those who have had prior heart attacks or are survivors of cardiac arrests. ICD therapy has been well established to show mortality reduction and benefit in both primary and secondary prevention.

The current transvenous systems are very effective but have a number of limits including anatomical limitations with venous access issues, implant risks eg cardiac perforation, lead failure risks leading to inappropriate shock therapy as well as explant risks.

The new EMBLEM™ MRI S-ICD system is entirely subcutaneous and does not require leads in the heart, leaving the vasculature untouched.

The device is placed using anatomical landmarks reducing the need for fluoroscopy at implant.

Sophisticated algorhythms provide effective detection and treatment of VT and VF.

The device is strongly considered particularly in young patients and those with life expectancy exceeding 10 years. It may be of use in patients where primary prevention is indicated and in patients with prosthetic heart valves.

The use of this device is to be avoided in patients requiring CRT, patients with symptomatic bradycardia and those where recurrent sustained monomorphic VT has been documented.

Diagram 1 – Subcutaneous ICD therapy

Diagram 2 Introduction to the EMBLEM™ MRI S-ICD

Read more: SCA Risk Factors – Subcutaneous ICD[268427]