This symposium is supported by Boston Scientific
Agenda
01:10: Introduction – Lluis Mont
03:05: Introduction to Modular ICD Therapy: A New Era in Personalised Cardiac Care – Clemens Steinwender
23:51: Modular CRM, Introducing an Upgrade Care Pathway Focusing on Patient Selection – John Paisey
37:41: Discussion and Q&A
Chaired by Lluis Mont (Barcelona, ES), this symposium featured Clemens Steinwender (Linz, AT) and John Paisey (Southampton, UK), discussing the evolution of modular ICD therapy in sudden cardiac death prevention. Dr Steinwender introduced the Boston Scientific modular Cardiac Rhythm Management (CRM) system, highlighting its two-component design: the EMBLEM S-ICD and the EMPOWER Leadless Pacemaker. This system allows for personalised treatment by offering subcutaneous defibrillation with the option of later adding antitachycardia pacing (ATP) for patients experiencing recurrent ventricular tachycardia. He underscored its benefits in reducing lead-related complications, referencing the PRAETORIAN and MODULAR ATP trials, which demonstrated the system’s efficacy and safety.
Dr Paisey expanded on patient selection and upgrade pathways, particularly for those at risk of developing bradyarrhythmias or requiring ATP. He discussed scenarios where patients with pre-existing SICDs could be upgraded with the EMPOWER Pacemaker, either for ATP or VVI pacing, though CRT remains unavailable in this leadless setup. The discussion explored the future of leadless technology, its role in reducing device-related complications and potential advancements, including atrial pacing and conduction system pacing. The faculty concluded that modular CRM therapy represents a step towards a leadless era, offering a more adaptable and patient-specific approach to ICD therapy.
