{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T07:51:26Z","timestamp":1781941886649,"version":"3.54.5"},"reference-count":8,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"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"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Patients with end\u2010stage renal disease (ESRD) on dialysis face a high risk of sudden cardiac death, but traditional transvenous implantable cardioverter\u2010defibrillators (TV\u2010ICD) carry risks of central venous stenosis and infection. Subcutaneous implantable cardioverter\u2010defibrillators (S\u2010ICD) provide an extravascular alternative, though comparative outcomes in dialysis patients remain limited.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study evaluated ESRD patients on hemodialysis who underwent S\u2010ICD or TV\u2010ICD implantation between January 2000 and March 2026 using the TriNetX global health network. A 1:1 propensity score matching (PSM) was utilized across 81 clinical covariates. Kaplan\u2010Meier survival analysis and Cox proportional hazards regression were used to assess long\u2010term outcomes, including infectious complications, dialysis access revisions, and mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following PSM, 456 matched pairs (\n N<\/jats:italic>\n \u00a0=\u00a0912) of ESRD patients on dialysis were identified. There were no significant differences between the S\u2010ICD and TV\u2010ICD cohorts regarding the composite outcome of sepsis, bacteremia, or transvenous lead extraction (53.5% vs. 55.1%;\n p<\/jats:italic>\n \u00a0=\u00a00.268). All\u2010cause mortality (58.7% vs. 60.4%;\n p<\/jats:italic>\n \u00a0=\u00a00.747) and hospitalization rates (87.9% vs. 85.4%;\n p<\/jats:italic>\n \u00a0=\u00a00.874) were also similar between the groups. However, S\u2010ICD was associated with higher rates of composite open and endovascular dialysis access revision (39.1% vs. 25.8%;\n p<\/jats:italic>\n \u00a0=\u00a00.001), percutaneous dialysis access intervention (p\u00a0=\u00a00.002), and dialysis access surgery (\n p<\/jats:italic>\n \u00a0=\u00a00.021).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n S\u2010ICD and TV\u2010ICD demonstrated similar rates of infectious complications, hospitalization, and all\u2010cause mortality in ESRD patients. S\u2010ICD implantation was associated with higher rates of dialysis access revisions and interventions. Device selection should remain individualized, guided by anatomy, access planning, and clinical context.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/pace.70330","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T07:39:47Z","timestamp":1781941187000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subcutaneous Versus Transvenous Implantable Cardioverter\u2010Defibrillators in End\u2010Stage Renal Disease: A Real\u2010World Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8503-484X","authenticated-orcid":false,"given":"Sabin","family":"Lama","sequence":"first","affiliation":[{"name":"Harrington Heart & Vascular Institute School of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4410-6125","authenticated-orcid":false,"given":"Yusef","family":"Saeed","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute School of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Shahrori","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute School of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawaf","family":"Alhabdan","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute School of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamin","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute School of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Sharma","sequence":"additional","affiliation":[{"name":"School of Medicine St. George's University St. George's True Blue, West Indies Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esseim","family":"Sharma","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute School of Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"e_1_2_4_2_1","unstructured":"United States Renal Data System.2025 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States.National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases;2025.https:\/\/usrds\u2010adr.niddk.nih.gov\/2025."},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.054"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.039818"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu274"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.07920520"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.11.050"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.05.081"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.11.013"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70330","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.70330","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T07:39:55Z","timestamp":1781941195000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.70330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":8,"alternative-id":["10.1111\/pace.70330"],"URL":"https:\/\/doi.org\/10.1111\/pace.70330","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"assertion":[{"value":"2026-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pace.70330"}}