Abstract
Background: To date, only a few comparisons between subcutaneous implantable cardioverter-defibrillator (S-ICD) patients undergoing and those not undergoing defibrillation testing (DT) at implantation (DT+ vs DT–) have been reported. Objective: The purpose of this study was to compare long-term clinical outcomes of 2 propensity-matched cohorts of DT+ and DT– patients. Methods: Among consecutive S-ICD patients implanted across 17 centers from January 2015 to October 2020, DT– patients were 1:1 propensity-matched for baseline characteristics with DT+ patients. The primary outcome was a composite of ineffective shocks and cardiovascular mortality. Appropriate and inappropriate shock rates were deemed secondary outcomes. Results: Among 1290 patients, a total of 566 propensity-matched patients (283 DT+; 283 DT–) served as study population. Over median follow-up of 25.3 months, no significant differences in primary outcome event rates were found (10 DT+ vs 14 DT–; P =.404) as well as for ineffective shocks (5 DT– vs 3 DT+; P =.725). At multivariable Cox regression analysis, DT performance was associated with a reduction of neither the primary combined outcome nor ineffective shocks at follow-up. A high PRAETORIAN score was positively associated with both the primary outcome (hazard ratio 3.976; confidence interval 1.339–11.802; P =.013) and ineffective shocks alone at follow-up (hazard ratio 19.030; confidence interval 4.752–76.203; P =.003). Conclusion: In 2 cohorts of strictly propensity-matched patients, DT performance was not associated with significant differences in cardiovascular mortality and ineffective shocks. The PRAETORIAN score is capable of correctly identifying a large percentage of patients at risk for ineffective shock conversion in both cohorts.
Original language | English (US) |
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Pages (from-to) | 2072-2079 |
Number of pages | 8 |
Journal | Heart Rhythm |
Volume | 18 |
Issue number | 12 |
DOIs | |
State | Published - Dec 2021 |
Keywords
- Defibrillation testing
- PRAETORIAN score
- Propensity matching
- Subcutaneous implantable cardioverter-defibrillator
- Sudden cardiac death
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)