Subcutaneous implantable cardioverter-defibrillator (S-ICD). Update 2022

Wolf S, Goetz G
Record ID 32018002663
Authors' objectives: Cardiovascular diseases often occur suddenly and unexpectedly and are a significant public health issue. This systematic review aimed to re-evaluate the evidence about the effectiveness and safety of the subcutaneous implantable cardioverter-defibrillator (S-ICD) compared to the transvenous implantable cardioverter-defibrillator (TV-ICD).
Authors' results and conclusions: The quality of the evidence for the effectiveness and safety outcomes were rated as "very low" to "moderate". The current evidence was insufficient to draw a definite conclusion about the effectiveness of S-ICDs compared to TV-ICDs. While the superiority of the S-ICD in terms of safety has not been demonstrated, there is moderate-quality evidence (1 RCT) that suggests non-inferiority of the S-ICDs versus the TV-ICDs. Furthermore, included studies indicate a statistically significantly lower risk for lead-related complications in patients with S-ICDs.
Authors' recommendations: Against this background, the recommendation of the first assessment in 2018 that S-ICDs are to be refunded with restrictions should be maintained. A re-evaluation is recommended not before 2024 after an ongoing RCT has been completed.
Authors' methods: In total, one randomised controlled trial (RCT), one post-hoc analysis of the RCT and four observational studies with a control group were included for the evidence synthesis.
Project Status: Completed
Year Published: 2022
URL for additional information:
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Defibrillators, Implantable
  • Cardiovascular Surgical Procedures
  • Tachycardia
  • Tachycardia, Supraventricular
  • Arrhythmias, Cardiac
  • Death, Sudden, Cardiac
  • Increased risk for sudden cardiac death
  • subcutaneous cardioverter-defibrillator
  • S-ICD
  • clinical effectiveness
  • safety
Organisation Name: Austrian Institute for Health Technology Assessment
Contact Address: Garnisongasse 7/20, A-1090 Vienna, Austria
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Contact Email:
Copyright: HTA Austria - AIHTA GmbH
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.