Long-term outcomes of subcutaneous implantable cardioverter defibrillators: the French nationwide HONEST study

European Heart Journal2025Fawzi Kerkouri, Christelle Marquié, Serge Boveda, Frédéric Anselme, Soraya Anys, Nicolas Badenco, Francis Bessiere, Hugues Blangy, Pierre Bordachar, Laure Champ-Rigot, Michel Chauvin, Nicolas Clementy, Gaël Clerici, Antoine da Costa, Pascal Defaye, Maxime de Guillebon, Jean-Claude Deharo, Romain Eschalier, Fabrice Extramiana, Laurent Fauchier, Pierre Frey, Estelle Gandjbakhch, Charles Guenancia, Benoit Guy-Moyat, Alexis Hermida, Jérôme Hourdain, Peggy Jacon, Laurence Jesel, Jérôme Lacotte, Christophe Leclercq, Nicolas Lellouche, Jacques Mansourati, Philippe Maury, Aymeric Menet, Pierre Mondoly, Mathieu Montoy, Kumar Narayanan, Jean-Luc Pasquié, David Perrot, Bertrand Pierre, Frédéric Sacher, Nicolas Sadoul, Victor Waldmann, Rodrigue Garcia, Vincent Probst, Eloi Marijon

European Heart Journal, 2025, ⟨10.1093/eurheartj/ehaf918⟩

Abstract Background and Aims Although use of the subcutaneous implantable cardioverter defibrillator (S-ICD) is increasing, evidence from industry-independent and unselected populations remains limited. Methods HONEST is a ongoing nationwide academic observational study enrolling 98.2% of patients implanted with an S-ICD across France (2012–2019). Five-year clinical endpoints were centrally adjudicated. Results Overall, 4924 patients were enrolled (mean age 49.9 ± 15 years, 76.7% male, 63.0% for primary prevention). Implants used general anaesthesia (78.9%), and defibrillation testing (82.6%). Perioperative complications (within 30 days) occurred in 4.4%. At 5 years, cumulative incidence rates were 13.8% for inappropriate shocks, 10.8% for early battery depletion, 2.4% for infections, 1.5% for lead dysfunction, and 1.4% for chronic discomfort. Reoperation was required in 16.9%, need for cardiac pacing in 3.1%, and definite S-ICD extraction in 8.4%. Inappropriate shocks were independently associated with male sex (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.14–1.46, P < .001), obesity (HR 1.35, 95% CI 1.02–1.79, P = .032), arrhythmogenic right ventricular cardiomyopathy (HR 1.70, 95% CI 1.03–2.81, P = .036), and the presence of a pacemaker (HR 2.20, 95% CI 1.16–4.17, P = .016). SMART Pass filtering significantly reduced inappropriate shocks (HR 0.67, 95% CI 0.50–0.89, P = .007). Among patients with inappropriate shocks, ∼1% developed induced ventricular fibrillation (one fatality), and 10% underwent device extraction. Ineffective shocks or undetected arrhythmias occurred in only 0.2%. Among 547 deaths (11.1%), 53.9% were cardiovascular, including 26 sudden deaths, and 8 were S-ICD/procedure-related, with none related to S-ICD extraction. Conclusions This nationwide study refines the long-term event profile of S-ICD therapy and may inform clinical practice and device selection.

Fawzi Kerkouri, Christelle Marquié, Serge Boveda, Frédéric Anselme, Soraya Anys, et al.. Long-term outcomes of subcutaneous implantable cardioverter defibrillators: the French nationwide HONEST study. European Heart Journal, 2025, ⟨10.1093/eurheartj/ehaf918⟩ (lien externe). ⟨hal-05428618⟩ (lien externe)

Citations

APA

Kerkouri, F., Marquié, C., Boveda, S., Anselme, F., Anys, S., Badenco, N., Bessiere, F., Blangy, H., Bordachar, P., Champ-Rigot, L., Chauvin, M., Clementy, N., Clerici, G., da Costa, A., Defaye, P., de Guillebon, M., Deharo, J.-C., Eschalier, R., Extramiana, F., … Marijon, E. (2025). Long-term outcomes of subcutaneous implantable cardioverter defibrillators: the French nationwide HONEST study. In European Heart Journal. https://dx.doi.org/10.1093/eurheartj/ehaf918

MLA

Kerkouri, Fawzi, et al. “Long-Term Outcomes of Subcutaneous Implantable Cardioverter Defibrillators: the French Nationwide HONEST Study.” European Heart Journal, Dec. 2025, https://dx.doi.org/10.1093/eurheartj/ehaf918.

Chicago

Kerkouri, Fawzi, Christelle Marquié, Serge Boveda, et al. 2025. “Long-Term Outcomes of Subcutaneous Implantable Cardioverter Defibrillators: the French Nationwide HONEST Study.” In European Heart Journal. https://dx.doi.org/10.1093/eurheartj/ehaf918.

Harvard

Kerkouri, F. et al. (2025) “Long-term outcomes of subcutaneous implantable cardioverter defibrillators: the French nationwide HONEST study,” European Heart Journal. Available at: https://dx.doi.org/10.1093/eurheartj/ehaf918.

ISO 690

KERKOURI, Fawzi, MARQUIÉ, Christelle, BOVEDA, Serge, ANSELME, Frédéric, ANYS, Soraya, BADENCO, Nicolas, BESSIERE, Francis, BLANGY, Hugues, BORDACHAR, Pierre, CHAMP-RIGOT, Laure, CHAUVIN, Michel, CLEMENTY, Nicolas, CLERICI, Gaël, DA COSTA, Antoine, DEFAYE, Pascal, DE GUILLEBON, Maxime, DEHARO, Jean-Claude, ESCHALIER, Romain, EXTRAMIANA, Fabrice, FAUCHIER, Laurent, FREY, Pierre, GANDJBAKHCH, Estelle, GUENANCIA, Charles, GUY-MOYAT, Benoit, HERMIDA, Alexis, HOURDAIN, Jérôme, JACON, Peggy, JESEL, Laurence, LACOTTE, Jérôme, LECLERCQ, Christophe, LELLOUCHE, Nicolas, MANSOURATI, Jacques, MAURY, Philippe, MENET, Aymeric, MONDOLY, Pierre, MONTOY, Mathieu, NARAYANAN, Kumar, PASQUIÉ, Jean-Luc, PERROT, David, PIERRE, Bertrand, SACHER, Frédéric, SADOUL, Nicolas, WALDMANN, Victor, GARCIA, Rodrigue, PROBST, Vincent and MARIJON, Eloi, 2025. Long-term outcomes of subcutaneous implantable cardioverter defibrillators: the French nationwide HONEST study [en ligne]. December 2025. Disponible à l'adresse : https://dx.doi.org/10.1093/eurheartj/ehaf918

Téléchargements