The SIDECAR 2.0 (S-ICD registry in European paediatric and young adult patients with congenital heart defects 2.0): an analysis of European S-ICD clinical practice and its evolution in paediatric patients
Year: 2025
Type: article
Study design: Observational Study
Abstract: AIMS: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are effective in patients who require protection from sudden cardiac death while avoiding the long-term risks associated with transvenous leads. However, data on their real-world performance in paediatric and young patients remain limited. This study aims to evaluate the safety and efficacy of S-ICDs in a large, multicentre cohort of paediatric and young patients across Europe, with a focus on contemporary implantation practices and clinical outcomes. METHODS AND RESULTS: This is an international, multicentre, observational, retrospective registry on S-ICD outcome in paediatric and young adult patients with congenital heart defects (CHD), cardiomyopathies, channelopathies, and idiopathic ventricular fibrillation (IVF). Data were collected on implantation techniques, acute and long-term outcomes, including defibrillation efficacy, inappropriate (IAS) and appropriate shocks, and complications. Follow-up data were analysed to assess device performance and safety. A total of 223 patients (mean age: 15 ± 3 years; 59% male, 53% cardiomyopathies, 18% channelopathies, 15% IVF, 14% CHD) were included. Most patients underwent implantation using an intermuscular (65%) and two-incision technique (88%). Acute defibrillation success was 100%, and no intraoperative complications occurred. The median follow-up was 28 (IQR: 12-55) months. Appropriate shocks were delivered in 41 (18%) patients (26% rate at 5 years). The first shock was effective in 92% of discrete episodes. The IAS and the complication rates were 20% and 5% at 5 years. Older age, intermuscular pocket, and two-incision technique were associated with fewer complications. CONCLUSION: This multicentre S-ICD European registry in paediatric and young patients demonstrated favourable outcomes, low IAS, and complication rates.
Source: EP Europace
Authors: Massimo Stefano Silvetti, Luc Bruyndonckx, Victor Waldmann, Roman Gebauer, László Környei, Tomasz Ksiazczyk, Vieira Illikova, Terezia Tavacova, Ferran Roses-Noguer, Joanna Kwiatkowska, Vincenzo Pazzano, Marie Wilkin, Christian Paech, Gábor Fésüs, Anastasia D Egorova, Piotr Wieniawski, Núria Rivas-Gandara, Maciej Kempa, Irma Battipaglia, Sophia Klehs, Michal Chalupka, Alice Maltret, Reinoud E Knops, Jan Janousek, Nico A Blom, Mariolina Lovecchio, Sergio Valsecchi, Fabrizio Drago
Institutions: Bambino Gesù Children's Hospital, Istituti di Ricovero e Cura a Carattere Scientifico, University of Antwerp, Antwerp University Hospital, Amsterdam University Medical Centers, Hôpital Necker-Enfants Malades, Université Paris Cité, Leipzig University, Gottsegen National Cardiovascular Center, Medical University of Warsaw, National Institute of Cardiovascular Diseases, Charles University, University Hospital in Motol, Vall d'Hebron Institut de Recerca, Gdańsk Medical University, Leiden University Medical Center, Hôpital Marie Lannelongue, Université Paris Descartes, Boston Scientific (United States)
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,909
OpenAlex ID: W4415711130