Observational studyEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Early complications and long-term outcomes of patients treated with a subcutaneous cardioverter-defibrillator: temporal trends and clinical implications of the anaesthetic strategies adopted at implant.
Observational study in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05302115 (coHOrte fraNcaise Des dEfibrillateurs Sous cuTanés), which is not on this map. Not yet cited in PubMed.
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coHOrte fraNcaise Des dEfibrillateurs Sous cuTanés
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Abstract
aimsSubcutaneous implantable cardioverter defibrillator (S-ICD) therapy is a well-established therapy for the prevention of sudden cardiac death. Although general anaesthesia (GA) was initially advocated for implantation, non-GA has emerged as a feasible alternative in clinical practice. This study evaluated the early and long-term outcomes associated with anaesthetic modality during S-ICD implantation procedures. METHODS AND
resultsThe nationwide, single-arm, observational HONEST cohort study included all patients implanted with an S-ICD (EMBLEM™, Boston Scientific) in France between 2012 and 2019. GA was characterised by controlled unconsciousness with airway management, while non-GA included all alternative techniques. Among 4924 patients, 1041 (21.1%) underwent non-GA. The proportion of non-GA use increased from 2.5% to 26.9% between 2012 and 2019 (P < 0.001). Patients undergoing implantation under non-GA tended to be older (51 ± 14 vs. 50 ± 15 years), had lower left ventricular ejection fraction (41 ± 16 vs. 43 ± 17%), and fewer secondary prevention indications (33 vs. 38%) (all P < 0.01). The 30-day complication rate was 3.4% in the non-GA group (vs. 3.7% in the GA group; P = 0.85). At follow-up, the incidence of overall complications (4.29 events per 100 person-years for non-GA vs. 4.73 for GA; P = 0.937), reintervention (1.21 vs. 1.62; P = 0.963), inappropriate shocks (2.88 vs. 2.78; P = 0.782), and all-cause mortality (2.93 vs. 2.56; P = 0.938) were similar between groups. Multivariable analysis confirmed that there were no differences across outcomes (all P values >0.1).
conclusionThe anaesthesia strategy used for S-ICD implantation was not associated with poorer short- or long-term clinical outcomes, supporting non-general anaesthesia as a feasible alternative in appropriately selected patients. CLINICALTRIALS.GOV ID: NCT05302115.
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