{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:40:20Z","timestamp":1779928820734,"version":"3.53.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Inappropriate shocks (IAS) remain a challenge for patients and physicians after implantation of the subcutaneous implantable cardioverter-defibrillator (S-ICD). The aims were to assess and characterize different patterns of IAS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Two hundred and thirty-nine patients were implanted with an S-ICD between 2010 and 2018 for primary and secondary prevention. Follow-up data of at least 6\u2009months were analysed. During a mean follow-up of 34.9\u2009\u00b1\u200916.0\u2009months, a total of 73 shocks occurred in 38 patients (6%). Forty-three (59%) shocks were considered appropriate due to ventricular tachycardia\/ventricular fibrillation, while 30 (41%) were inappropriate and occurred in 19 patients (8%). Myopotentials\/noise was the most frequent cause of inappropriate shocks (n\u2009=\u20098), followed by T-wave oversensing (n\u2009=\u20096) and undersensing of the QRS, resulting in adaptation of the automatic gain control and inappropriate shock (n\u2009=\u20095). Seventy-four percent of all IAS occurred on the primary vector, while no IAS occurred on the alternate vector. In seven of eight patients (88%), IAS related to myopotentials have occurred on the primary sensing vector. Multivariate analysis identified taller patients, primary sensing vector and first-generation S-ICD device as predictors for IAS. SMART pass effectively reduced the occurrence of IAS in the second-generation S-ICD system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Inappropriate therapies are less frequently observed on the alternate vector. The primary vector seems to be unfavourable with regard to oversensing caused by myopotentials. Inappropriate shocks were associated with an increased rate of rehospitalization but not mortality. These observations have implications for the prevention of inappropriate S-ICD shocks.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa026","type":"journal-article","created":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T12:18:42Z","timestamp":1579781922000},"page":"761-768","source":"Crossref","is-referenced-by-count":21,"title":["Incidence, mechanisms, and clinical impact of inappropriate shocks in patients with a subcutaneous defibrillator"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2275-7149","authenticated-orcid":false,"given":"Boris","family":"Rudic","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erol","family":"T\u00fcl\u00fcmen","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Fastenrath","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"R\u00f6ger","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Goranova","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Akin","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Borggrefe","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Kuschyk","sequence":"first","affiliation":[{"name":"1st Department of Medicine - Cardiology, University Medical Centre Mannheim, D-68167 Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"2020050704575928900_euaa026-B1","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1056\/NEJMoa013474","article-title":"Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction","volume":"346","author":"Moss","year":"2002","journal-title":"N Engl J Med"},{"key":"2020050704575928900_euaa026-B2","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1056\/NEJMoa1211107","article-title":"Reduction in inappropriate therapy and mortality through ICD programming","volume":"367","author":"Moss","year":"2012","journal-title":"N Engl J Med"},{"key":"2020050704575928900_euaa026-B3","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1056\/NEJMoa0909545","article-title":"An entirely subcutaneous implantable cardioverter-defibrillator","volume":"363","author":"Bardy","year":"2010","journal-title":"N Engl J Med"},{"key":"2020050704575928900_euaa026-B4","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1161\/CIRCULATIONAHA.113.003042","article-title":"Safety and efficacy of a totally subcutaneous implantable-cardioverter defibrillator","volume":"128","author":"Weiss","year":"2013","journal-title":"Circulation"},{"key":"2020050704575928900_euaa026-B5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.hrthm.2016.11.025","article-title":"Performance of the subcutaneous implantable cardioverter-defibrillator in patients with a primary prevention indication with and without a reduced ejection fraction versus patients with a secondary prevention indication","volume":"14","author":"Boersma","year":"2017","journal-title":"Heart Rhythm"},{"key":"2020050704575928900_euaa026-B6","first-page":"1601","article-title":"2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). 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