Guidance of Clinical Magnet Application of Inhibition of Inappropriate Shock in Patient of Subcutaneous Implantable Cardioverter Defibrillators: A Review of the Literature

Background: The subcutaneous implantable cardioverter defibrillator (S-ICD) represents a major advancement in ICD technology in the last 10 years. During the experience with the 1nd generation of S-ICD, the IAS rate was 4,5% to 25% and with 2nd generation and 3nd generation of S-ICD the IAS rate was 3.1% at one year. Indeed, in the hospital and out of hospital emergency situations in presence of IAS it is mandatory to suspend the shock therapy.

Objective: In this study we performed a review of literature provides a comprensive overview of the current literature on the specific responses of S-ICD to clinical magnets to IAS reduce in the emergency situations.

Methods: A systematic search was limited between 2010 to 2020 in the database.

Results: Few prospective reports with a small number of patients have been published, revealing no relevant adverse events in patients with IAS. Six case reports on direct magnet application in S-ICD patients have been published, with many of them occurring in older devices and IAS.

Conclusion: In cases of cardiac and extracardiac malfunctions in S-ICD patients, a magnet can be used as a first step therapy to temporarily deactivate shocks in emergency situations. In the absence of a specific Boston Scientific magnet, any magnet can be used interchangeably for S-ICD deactivation therapy.

Keywords:Subcutaneous implantable cardioverter defibrillator; Inappropriate shock; Clinical magnet; Deactivation shock therapy