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Background and purpose <p>T-wave oversensing is the leading cause of inappropriate shocks in subcutaneous ICDs (S-ICDs). This study assessed S-ICD eligibility in ventricularly paced patients using automated screening at rest and during exercise.</p> Methods <p>Fifty patients with a dual-chamber pacemaker or ICD, or a cardiac resynchronization therapy device (CRT), and paced QRS complexes were screened. Eligibility was defined as at least one acceptable sensing vector at rest (supine and standing) and during treadmill exercise at 100&#xa0;bpm.</p> Results <p>Mean age was 72.4 ± 9 years, 80% male. Of the 50 patients (46 patients (92%) had dual-chamber and 4 CRT devices), 17 (34%) passed screening at rest, but only 8 (16%) remained eligible during exercise. Right ventricular (RV) lead position and electrocardiographic (ECG) features showed no significant impact.</p> Conclusion <p>S-ICD eligibility is low among paced patients, and exercise further reduces suitability. Unlike non-paced patients, screening in this group should routinely include exercise evaluation.</p> Graphical Abstract <p></p>

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Evaluation of subcutaneous implantable cardioverter defibrillator eligibility in ventricularly paced patients during rest and exercise: a prospective observational study

  • 期刊论文

  • 发表日期：

    2026年1月15日

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  • Georgios Leventopoulos,
  • Kornilia Pepa,
  • Kassiani-Maria Nastouli,
  • Maria Bozika,
  • Georgios Vasilagkos,
  • Georgios Boliaris,
  • Rafail Koros,
  • Efthimia Kapsali,
  • Georgia Xygka,
  • Ioanna Koniari,
  • Angelos Perperis,
  • Konstantinos P. Letsas,
  • Sotirios Xydonas,
  • Periklis Davlouros

摘要

Background and purpose

T-wave oversensing is the leading cause of inappropriate shocks in subcutaneous ICDs (S-ICDs). This study assessed S-ICD eligibility in ventricularly paced patients using automated screening at rest and during exercise.

Methods

Fifty patients with a dual-chamber pacemaker or ICD, or a cardiac resynchronization therapy device (CRT), and paced QRS complexes were screened. Eligibility was defined as at least one acceptable sensing vector at rest (supine and standing) and during treadmill exercise at 100 bpm.

Results

Mean age was 72.4 ± 9 years, 80% male. Of the 50 patients (46 patients (92%) had dual-chamber and 4 CRT devices), 17 (34%) passed screening at rest, but only 8 (16%) remained eligible during exercise. Right ventricular (RV) lead position and electrocardiographic (ECG) features showed no significant impact.

Conclusion

S-ICD eligibility is low among paced patients, and exercise further reduces suitability. Unlike non-paced patients, screening in this group should routinely include exercise evaluation.

Graphical Abstract