Disadvantages of subcutaneous ICD – Cardiology MCQ – Answer
Disadvantages of subcutaneous ICD (Implantable cardioverter defibrillator) include all of the following except – Correct answer: d) Higher chance of lead failure
Subcutaneous ICDs have no leads. Leads are the Achilles heel of the pacing systems and ICDs. They tend to fail more often than the device itself and have more associated complications. It was to overcome this shortcoming that the subcutaneous ICDs were designed. But they suffer from the disadvantages mentioned in the other options. Very often patients may have indication for pacemaker with intermittent bradyarrhythmias in addition to the ventricular tachyarrhythmias which the ICDs are designed to treat. Antitachycardia pacing is a function in conventional ICDs which can avoid shocks by terminated relatively slower ventricular tachycardias by overdrive pacing. Many patients requiring ICDs have left ventricular dysfunction and satisfy the criteria for a combo device with both ICD and CRT. This combo function is not feasible with subcutaneous ICD.
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