Healthcare Matters

The U.S. FDA has granted Boston Scientific Corporation (NYSE: BSX) regulatory approval for its S-ICD® System, the world’s first and only commercially available subcutaneous implantable defibrillator (S-ICD). The device is tailor made for roughly 850,000 U.S. patients who are considered at risk for sudden cardiac arrest (SCA).  The S-ICD System sits entirely below the skin without the need for electrodes or “leads” to be placed into the heart.  This leaves the heart and blood vessels untouched, offering patients an alternative to transvenous implantable cardioverter defibrillators (ICDs), which require leads to be placed in the heart itself. These systems have been problematic, causing what is referred to as “electrical storms” in patients –a condition aptly described. The new system from Boston Scientific has two main components: (1) the pulse generator, which powers the system, monitors heart activity, and delivers a shock if needed, and (2) the electrode, which enables the device to sense the cardiac rhythm and deliver shocks when necessary.  Both components are implanted just under the skin—the generator at the side of the chest, and the electrode beside the breastbone. Implantation with the S-ICD System is straightforward using anatomical landmarks, without the need for fluoroscopy (an x-ray procedure that makes it possible to see internal organs in motion).  Fluoroscopy is required for implanting the leads attached to transvenous ICD systems.

“The S-ICD System establishes the first new category of cardiac rhythm management devices since the introduction of cardiac resynchronization therapy,” said Raul Weiss, M.D., Associate Professor-Clinical, Cardiovascular Medicine at The Ohio State University.  ”Doctors now have a breakthrough treatment option that provides protection from sudden cardiac arrest without touching the heart.” Approval of the S-ICD System was based on data from a 330-patient, prospective, non-randomized, multicenter clinical study, which evaluated the safety and effectiveness of the system in patients at risk of SCA. The S-ICD System met the primary endpoints of the study, and results were presented earlier this year at the Heart Rhythm Society 33rd Annual Scientific Sessions. The study results support that the S-ICD System is an important new treatment option for a wide range of primary and secondary prevention patients.

Boston Scientific’s CEO, HanK Kucheman, has been quick to point out the significance of the new product to the company’s product portfolio. “We are the only company to offer an FDA-approved subcutaneous implantable defibrillator and expect this to be the case for several years.  The S-ICD System, coupled with our numerous recent regulatory approvals and our other innovative products, such as the WATCHMAN® Left Atrial Appendage Closure Device and Alair® Bronchial Thermoplasty System for the treatment of severe asthma, demonstrates our continued commitment to developing and bringing to market innovative products for physicians and their patients.”

Sudden cardiac arrest is an abrupt loss of heart function. “Each year, thousands of patients indicated for an ICD are not referred to a specialist and remain untreated,” said William T. Abraham, MD, FACC, Director, Division of Cardiovascular Medicine at The Ohio State University Heart Center.  ”The S-ICD System is an important new treatment option that has the potential to improve patient acceptance of ICD therapy.”

Boston Scientific expects to begin a phased launch of the S-ICD System that will expand over time as medical professionals are trained on the safe and effective use of the system.  The company acquired the S-ICD System earlier this year when it completed the acquisition of Cameron Health, Inc.  The S-ICD System received CE Mark in 2009 and is commercially available in many countries in Europe as well as in New Zealand.  To date, more than 1,400 devices have been implanted in patients around the world.

Source: PRNewswire

—Tom Finn