Outcomes associated with subcutaneous implantable cardioverter defibrillators

To the Editor We read with interest the article by Friedman et al ¹ titled, “Trends and In-Hospital Outcomes Associated With Adoption of the Subcutaneous Implantable Cardioverter Defibrillator in the United States.” They reported that a high proportion of patients in their study had elevated creatinine levels and that 20.1% were on dialysis. A decreasing trend in defibrillation threshold testing (DFT) was noted. Defibrillation threshold was performed in only three-fourths of patients, despite carrying a class I indication. Among patients who had periprocedural cardiac arrest, 5 of them were undergoing dialysis. Among these 5 patients, 1 had high DFT, but DFT was not performed in 3 other patients. Overall, in patients with subcutaneous implantable cardioverter defibrillators, an increased rate of periprocedural cardiac arrest was observed.