Early Failure of Subcutaneous ICD in a Patient With a Variant of Rapidly Progressive ARVC
Bibliographic record
Abstract
BACKGROUND: A subcutaneous implantable cardioverter defibrillator (S-ICD) is a validated alternative to a transvenous ICD for patients without pacing indications. However, limited data exist regarding its safety and efficacy in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). CASE SUMMARY: A 21-year-old man was referred after a syncope during a sport event. A 12-lead electrocardiogram showed repolarization abnormalities, and cardiac magnetic resonance demonstrated right ventricular dilatation, biventricular dysfunction, and fibrosis compatible with a diagnosis of ARVC. An S-ICD was implanted after successful preimplant screening. Genetic testing identified a known pathogenic plakophilin-2 variant. The patient received an S-ICD. At 18 months, lead noise, undersensing, and oversensing occurred because of reduced QRS amplitude. Imaging confirmed disease progression. The S-ICD was explanted and replaced by a transvenous ICD. The patient was referred for heart transplant evaluation. DISCUSSION: Our case represents a phenotype variant of ARVC with failure of the S-ICD system due to a temporal change in QRS amplitude over a short period of time. Advanced discrimination algorithms on the S-ICD may not be sufficient to prevent device failure. Cardiac magnetic resonance and genetic testing could eventually play a major role in the selection of a device in patients with ARVC. TAKE-HOME MESSAGE: This case illustrates S-ICD failure associated with rapidly progressive ARVC, underscoring the need for close follow-up and tailored device selection in this population.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".