PRAETORIAN

Subcutaneous vs Transvenous Defibrillator Therapy

Paziente / Popolazione Intervento / Esposizione Confronto Esito

In 849 patients needing a defibrillator but no pacing, a subcutaneous ICD was non-inferior to a transvenous ICD for device complications and inappropriate shocks.

849

Disegno

RCT, non-inferiority

Esito

Device complications + inappropriate shocks

Rilevanza

RisultatoNon-inferior; primary endpoint 15.1% vs 15.7% (68 vs 68 pts), HR 0.99 (95% CI 0.71–1.39), P=0.01 for non-inferiority; P=0.95 superiority.

Knops RE, et al. N Engl J Med. 2020;383(6):526-536. 10.1056/NEJMoa1915932

Discussione e critica

Trades lead complications for more inappropriate shocks and no pacing or anti-tachycardia therapy. Suits patients with no pacing or resynchronisation indication.