1374.1 – Subcutaneous implantable cardioverter defibrillator therapy for the prevention of sudden cardiac death

New MBS item.

The proposed service involves the insertion of subcutaneous implantable cardioverter defibrillator (S-ICD) leads. Insertion of the S-ICD system is clinically similar to the insertion of a transvenous ICD; however, the subcutaneous lead does not need to be inserted into the vasculature of the heart. Rather, it is placed under the skin of the patients’ chest. The implantation of S-ICD leads requires the use of a compatible ICD generator; however, the procedure for implanting the generator remains unchanged (i.e. subcutaneous). Therefore, a new or amended service for implantation of a subcutaneous ICD generator is not requested.

Type: Therapeutic

S-ICD is primarily indicated for patients with underlying congenital or structural cardiac abnormalities, or with limited or difficult vascular access. Often these patients are quite young and may require multiple replacements of transvenous ICD leads over the course of their lives, leading to an elevated risk of serious complications, especially infection. A functional limitation of current S-ICD devices is that they cannot provide long-term bradypacing or antitachycardia pacing (ATP). S-ICD is therefore only indicated in patients who do not have symptomatic bradycardia, incessant VT, or spontaneous, frequently occurring VT that is reliably terminated with ATP.

• PASC meeting: Expedited – Bypassing PASC
• ESC meeting: 11 - 12 February 2021
• MSAC meeting: 31 March - 1 April 2021