{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:39:10Z","timestamp":1777628350762,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The subcutaneous implantable cardioverter defibrillators (S\u2010ICD) in hypertrophic cardiomyopathy (HCM) remains controversial. HCM patients are often younger and exposed to longer\u2010term risks: complications and inappropriate therapy (IT). The S\u2010ICD avoids vascular risks associated with transvenous ICDs (TV\u2010ICD), but the rate of IT remains a concern. We conducted a retrospective observational study in HCM patients who received ICDs: assessing outcomes and utilizing a multi\u2010event statistical model, we provide a novel assessment of the cumulative complication risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study of all HCM patients who received an ICD at a tertiary center from 2006 to 2022 was conducted, utilizing electronic pacing and health records. Cox\u2010proportion hazard models were applied for comparative outcome analysis and a multi\u2010event statistical model was used to assess the cumulative burden of complications. Propensity score matching was used to adjust for baseline differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analysed data from 611 patients, with 141 receiving S\u2010ICDs (26.7%). S\u2010ICD patients had significantly fewer complications over a maximal follow\u2010up of 137\u00a0months (HR 0.309, 95% CI 0.103\u20130.923,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.035). Multi\u2010event analysis demonstrated a cumulative increase in complications over time for TV\u2010ICD patients (HR 0.258, 95% CI 0.109\u20130.644,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004), conversely no S\u2010ICD patients experienced multiple complications. There was no difference in therapy rates or mortality between matched groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The S\u2010ICD is associated with fewer complications than TV\u2010ICD, this is amplified by multi\u2010event analysis, but without differences in IT. This should be discussed with HCM patients, as the S\u2010ICD could provide a better benefit\/risk ratio.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70133","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T18:07:51Z","timestamp":1768846071000},"page":"551-562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["S\u2010ICD in Hypertrophic Cardiomyopathy: Fewer Complications Without Increased Inappropriate Shocks Versus Transvenous Systems"],"prefix":"10.1111","volume":"49","author":[{"given":"Christopher","family":"Monkhouse","sequence":"first","affiliation":[{"name":"Barts Heart Centre West Smithfield  London UK"},{"name":"William Harvey Research Institute Queen Mary University of London (QMUL)  London 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