S-ICD

Hi all,

Has anyone got any first hand knowledge about the S-ICD's? Have heard some pros and cons so hoping to get some feedback prior to my implantation (still trying to decide on the type to go with).

Thanks,
Marc

3 Comments

S-ICD

by golden_snitch - 2014-11-20 01:11:04

Hi Marc,

I don't have an ICD, but I have followed the development of the S-ICD very closely as a former EP of mine is one of the patent holders for it.

The thing is, the S-ICD can't really do much: It cannot pace at all all, and it cannot do any anti-tachycardia pacing (ATP, in some patients stops VT before a shock is necessary). All it can do is to shock. And it needs to deliver more energy when it shocks than a normal ICD, because there is no lead inside the heart. The S-ICD can, as far as I know, not be home monitored like most other ICDs. Last but not least, it's a huge device. ICDs are already big, but the S-ICD is even bigger.

But, of course, it depends on your condition. If you have a ventricular arrhythmia that cannot be stopped by ATP, but for which you always need to be shocked, the S-ICD would be an option. If you have VT with a good chance that ATP stops it before a shock is delivered, if I were you, I'd prefer that. Also, if you already have several pacemaker or ICD leads in your veins and/or have had complications from these, the S-ICD might be an option to avoid more transvenous leads.

If I were to get an ICD (now only have a pacemaker), I'd want one that is comparatively small, can pace, has remote monitoring, and can deliver ATP therapies. But that's just me.

Good luck!

Inga

It's a KIA

by mrag - 2014-11-20 09:11:22

I think Inga has given an excellent summary on the S-ICD. I might stress the big advantage I see to it is there are no leads/wires threaded into the heart. Any shocks I would imagine would feel the same-a real kick in the chest. Despite testing, the ICD has also been around quite a bit longer (don't think that important, how come I already get unsolicited calls from lawyers wanting to sue Xarelto?).

I suspect in the end, your insurance company and your EP will be making the final determination on what you should have. It won't be your call. For me though, I'd be leaning towards the ICD-more programming options, more experience, more users. It's sexier too as it can show through your chest if you're skinny enough.

Decision

by Olena - 2014-11-26 12:11:34

Hi Marc,
My doctor told me that all I need is an S-ICD to shock me in case of pass out. I was also debating between ICD and S-ICD. From what I've heard, regular ICD can cause serious complications, and in my apperently young age - 40, my doctor told me that it's a difficult decision Regular ICD has more functions and have been around for many years. S-ICD will have a smaller version sometime next year. And from what I know they are planning to add more options, but it might take more years. I am waiting for a smaller verion to be implanted. If in the future I will need to change to regular ICD, I will do that. But for now S-ICD should work for me. It's depends on what you need it for.

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