Advances in ICD Technology: Extravascular ICDs, Subcutaneous ICDs, Shock Efficiency (non-ACE)-Advances in ICD Technology: Extravascular ICDs, Subcutaneous ICDs, Shock Efficiency (non-ACE)

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Video Summary

The session chaired by Kumar Narayanan focused on advances in ICD technology, featuring a series of oral presentations highlighting the latest research and developments in the field. Dr. Karim Saleh discussed EVICD implantation in pediatric patients, highlighting the challenges and benefits of this technology for children with higher complication rates from traditional ICDs. His research showed successful implantations in a small cohort without immediate complications, suggesting potential benefits for young patients at risk of sudden cardiac death.<br /><br />Dr. Claudio Suja presented on the MADIT-ICD benefit score, which reassesses ICD implantation benefits in the current era of modern programming and medical therapies. The analysis questioned the utility of ICDs for primary prevention given substantial competing risks from nonarrhythmic mortality, suggesting a need for refined risk stratification.<br /><br />Dr. Michael Kletcher discussed improvements in ICD shock efficacy using programmable pulse width, demonstrating enhanced shock success rates compared to traditional fixed-tilt methods. His study suggested that reprogramming ICDs with fixed pulse width could benefit patients receiving shock therapies, offering better outcomes with potentially lower energy requirements.<br /><br />Dr. Marco Schiavone evaluated the Praetorian score's effectiveness and defibrillation testing in predicting outcomes for patients with subcutaneous ICDs, emphasizing that integrating the Praetorian score with factors like BMI and impedance improves predictive accuracy for shock efficacy.<br /><br />Lastly, Dr. Alfonso Aranda-Hernandez introduced a novel method to assess short-term variability of repolarization (STV) as a predictive tool for ventricular arrhythmic events, underlining its potential as a future clinical tool for arrhythmia prediction. His study supports the need for embedded device algorithms for proactive patient management.

Keywords

ICD technology

EVICD implantation

pediatric patients

MADIT-ICD benefit score

risk stratification

programmable pulse width

shock efficacy

Praetorian score

subcutaneous ICDs

repolarization variability