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, 30 5 2025, Pages euaf276 The Sidecar 2.0 (S-ICD Registry in European Paediatric and Young Adult Patients with Congenital Heart Defects 2.0): An Analysis of European S-ICD Clinical Practice and its Evolution in Paediatric Patients. Silvetti MS, Bruyndonckx L, Waldmann V, Gebauer R, Környei L, Ksiazczyk T, Illikova V, Tavacova T, Noguer FR, Kwiatkowska J, Pazzano V, Wilkin M, Paech C, Fésüs G, Egorova AD, Wieniawski P, Gandara NR, Kempa M, Battipaglia I, Klehs S, Chalupka M, Maltret A, Knops RE, Janousek J, Blom NA, Lovecchio M, Valsecchi S, Drago F
Background
Subcutaneous implantable cardioverter-defibrillators (S-ICD) are effective in patients who require protection from sudden cardiac death while avoiding the long-term risks associated with transvenous leads. However, data on their real-world performance in paediatric and young patients remain limited.
Objective
To evaluate the safety and efficacy of S-ICDs in a large, multicentre cohort of paediatric and young patients across Europe, with a focus on contemporary implantation practices and clinical outcomes.
Methods
This is an international, multicentre, observational, retrospective registry on S-ICD outcome in paediatric and young adult patients with congenital heart defects (CHD), cardiomyopathies, channelopathies, and idiopathic ventricular fibrillation (IVF). Data were collected on implantation techniques, acute and long-term outcomes, including defibrillation efficacy, inappropriate (IAS) and appropriate shocks, and complications. Follow-up data were analysed to assess device performance and safety.
Results
A total of 223 patients (mean age: 15±3 years; 59% male, 53% cardiomyopathies, 18% channelopathies, 15% IVF, 14% CHD) were included. Most patients underwent implantation using an intermuscular (65%) two-incision technique (88%). Acute defibrillation success was 100%, and no intraoperative complications occurred. The median follow-up was 28 (IQR: 12-55) months. Appropriate shocks were delivered in 41 (18%) patients (26% rate at 5 years). The first shock was effective in 92% of discrete episodes. The IAS and the complication rates were 20% and 5% at 5 years. Older age, intermuscular pocket, and 2-incision technique were associated with fewer complications.
Conclusions
This multicentre S-ICD European registry in paediatric and young patients demonstrated favourable outcomes, low IAS and complication rates.
