How likely is the sense‐B‐noise to affect patients with subcutaneous implantable cardioverter‐defibrillators and can we solve that problem in every case?

Abstract

AbstractBackgroundSense‐B‐noise is a newly reported possible cause of inappropriate shocks in patients with subcutaneous implantable cardioverter‐defibrillators (S‐ICDs). The nature of that noise is unknown, it is not related to mechanical failure of the S‐ICD system. Reprogramming to the secondary sensing vector is suggested by the producer as a possible solution.MethodsWe analyzed the medical records of S‐ICD recipients from two university clinical centers (Gdansk and Szczecin, Poland). Our aim was to determine the rate of sense‐B‐noise, and whether the secondary sensing vector would be available for reprogramming if such a problem occurred in our patients.ResultsThe sense‐B‐noise issue affected three patients in our cohort (3%), which corresponds to the incidence of 0.012 events per patient‐year of follow‐up. The primary vector was permanently used in 47 patients (52%), secondary in 28 (31%), and alternate in 16 (17%), respectively. Therefore, the total number of patients potentially vulnerable to sense‐B noise (with the primary or alternate vector programmed permanently) was 63 (69%). Among those 63 patients, 51 individuals (81%) had also the secondary vector available for permanent use.ConclusionThe sense‐B‐noise affected 3% of patients in our cohort, with an incidence of 0.012 per patient‐year of follow‐up. Most patients potentially vulnerable to sense‐B noise could be reprogrammed to the secondary sensing vector, if necessary. Further investigation of the sense‐B‐noise issue is needed.