Premature battery depletion can affect a quarter of subcutaneous cardioverter defibrillators

A retrospective registry analysis assessing premature battery depletion and Sense-B-Noise in 2,071 patients with subcutaneous cardioverter-defibrillators (S-ICD) found that premature battery depletion impacts 27% of patients with an S-ICD.

Dr Jonas Wörmann (University of Cologne, Germany) and colleagues analysed a multicentre registry to determine the incidence of premature battery depletion and Sense-B-Noise in participants with an S-ICD implanted between 2015–2023 [1]. Devices suspected of Sense-B-Noise were analysed for saturation signal, diminished QRS complexes, and whether they led to inappropriate shock in participants. Devices suspected of premature battery depletion were analysed for depletion within 60 months (i.e. the manufacturer’s warranty time), sudden drop in expected longevity, and confirmation by technical analyses.

In total, 1,013 participants were analysed for premature battery depletion over a median follow-up of 47 months (IQR 24­64). Of these participants, 498 (48.8%) had potentially affected devices. Of the affected devices, the generator lifetime was lower than 60 months in 9.5% of cases. Premature battery depletion was clinically suspected in 27.1% of cases. Forty devices were explanted for analysis, and premature battery depletion was detected in 30 (90%) of these devices.

Furthermore, 1,058 participants were analysed for Sense-B-Noise. Of these, 9.7% had an inappropriate shock, and 5 (0.5%) had confirmed Sense-B-Noise, with a median lead dwell time of 23 months (IQR 3–27) in affected participants. Three devices were submitted to the manufacturer, but no system abnormalities were found confirming Sense-B-Noise as the cause for the inappropriate shock.

“Premature battery depletion led to a substantial loss of device function with the expected longevity of 8.7 years in S-ICD patients in the overall cohort,” said Dr Wörmann. “Sense-B-Noise is a rare phenomenon leading to inappropriate shock, with a challenging diagnosis and management with causes remaining elusive.”

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   1. Wörmann J, et al. Incidence of premature battery depletion and Sense-B-noise lead failure in subcutaneous cardioverter-defibrillator patients: A comprehensive analysis of a large multicenter registry. Late-Breaking Science: devices. EHRA Congress 2024, 7–9 April, Berlin, Germany.

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Posted on 29 April, 202429 April, 2024