Effects of EMBLEM MRI subcutaneous implantable defibrillator (S-ICD) on tricuspid regurgitation and hybrid strategy for secondary prevention of cardiac death

Tricuspid regurgitation is a disease that occurs when the tricuspid valve does not close properly and is a risk factor for heart failure.

Key findings from the analysis: At six months, patients in the TV-ICD group were seven times more likely to have worsening tricuspid regurgitation. Of those with worsening tricuspid regurgitation, moderate or severe symptoms developed in 6.9% of patients receiving a TV-ICD versus 2.3% of those receiving an S-ICD.

-Hybrid strategy for secondary prevention of sudden cardiac death using ventricular tachycardia (VT) ablation and the EMBLEM MRI S-ICD: The prospective, investigator-sponsored VTabl-SICD trial explored among 32 patients the safety and efficacy of a novel hybrid management strategy combining VT ablation with S-ICD implantation in patients who have scar-related VT. Findings from the study suggested that the combination strategy was superior to conventional TV-ICD implantation for the secondary prevention of sudden cardiac death by significantly reducing the need to deliver ICD therapy and avoiding untreated, symptomatic arrhythmias. At two years, the rate of delivery of any appropriate ICD therapy was significantly lower in the VTabl-S-ICD group compared to the TV-ICD group. There were no cases of untreated symptomatic VT or ventricular fibrillation in the VTabl-S-ICD group.