Subcutaneous implantable cardioverter-defibrillator therapy in Poland: Results of the Polish S-ICD Registry.

BACKGROUND: The use of a subcutaneous implantable cardioverter-defibrillator (S-ICD) has been expanding in Poland since 2014. The Polish Registry of S-ICD Implantations was held by the Heart Rhythm Section of the Polish Cardiac Society between May 2020 and September 2022 to monitor the implementation of that therapy in Poland.

AIMS: To investigate and present the state-of-the-art of S-ICD implantation in Poland.

METHODS: Implanting centers reported clinical data of patients undergoing S-ICD implantations and replacements, including: age, gender, height, weight, underlying disease, history of pacemaker and defibrillator implantations, indications for S-ICD, electrocardiographical parameters, procedural techniques, and complications.

RESULTS: 440 patients undergoing S-ICD implantation (411) or replacement (29) were reported by 16 centers. Most patients were in New York Heart Association class II (218 patients, 53%) or I (150 patients, 36.5%). Left ventricular ejection fraction was 10-80%, median (IQR) 33% (25%‒55%). Primary prevention indications were present in 273 patients (66.4%). Non-ischemic cardiomyopathy was reported in 194 patients (47.2%). The main reason for the choice of S-ICD were: young age (309, 75.2%), risk of infective complications (46, 11.2%), prior infective endocarditis (36, 8.8%), hemodialysis (23, 5.6%), and immunosuppressive therapy (7, 1.7%). Electrocardiographic screening was performed in 90% of patients. The rate of adverse events was low (1.7%). No surgical complications were observed.

CONCLUSIONS: Qualification for S-ICD in Poland was slightly different when compared to the rest of Europe. The implantation technique was mostly consistent with the current guidelines. S-ICD implantation was safe, and the complication rate was low.