Totally subcutaneous implantable cardioverter defibrillator (S-ICD) has recently been established in clinical practice and represents a valid alternative to the transvenous ICD (TV-ICD), while being beneficial in avoiding complications associated with transvenous endocardial leads. The pulse generator of the S-ICD has a large volume in comparison to a TV-ICD, which requires the preparation of a larger device pocket and distinct surgical technique compared to the traditional TV-ICD. Initial data of real subcutaneous implantation technique showed high rates of complications, for example, infections or skin erosions.^1–4 Although S-ICD has a lower risk of lead-related complications than TV-ICD, the incidence of non-lead-related complications was higher for S-ICD than for TV-ICD. Especially the rate of pocket infections in S-ICD procedures in the earlier studies appeared to be up to four-fold higher than reported for conventional TV-ICDs (0.7%–1.2%).^5–8 Altered immune function in patients with diabetes mellitus (DM) is suspected to lead to an increased risk of infections.⁹ In general, wound healing problems occur more frequently in patients with DM.^10,11 Due to higher riks for long-term lead infection rates in DM patients, S-ICD implantation is favorable. It remains unclear if these patients are going to suffer more often from the previously reported pocket infection problems in short-term. The objective of this study was to further evaluate the role of DM in a consecutive group of patients undergoing S-ICD implantation surgery in our single-centre study with respect to the procedural short-term outcome, including peri- and postoperative complications.

中文翻译：

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糖尿病作为皮下植入式心脏复律除颤器植入患者的危险因素的影响：一项单中心研究。

全皮下植入式心脏复律除颤器（S-ICD）最近已在临床实践中确立，代表了经静脉ICD（TV-ICD）的有效替代方案，同时有利于避免与经心内膜导联相关的并发症。与TV-ICD相比，S-ICD的脉冲发生器体积较大，与传统的TV-ICD相比，S-ICD的脉冲发生器需要准备更大的设备袋和独特的手术技术。真正的皮下植入技术的初始数据显示出很高的并发症发生率，例如感染或皮肤糜烂。^1–4尽管S-ICD发生铅相关并发症的风险低于TV-ICD，但S-ICD发生非铅相关并发症的发生率高于TV-ICD。尤其是在早期研究中，S-ICD手术中的口袋感染率似乎比传统TV-ICD的报道高出四倍（0.7％–1.2％）。^5–8怀疑糖尿病（DM）患者的免疫功能改变会导致感染风险增加。⁹通常，DM患者的伤口愈合问题更常见。^10,11由于DM患者长期铅感染率较高，因此S-ICD植入是有利的。目前尚不清楚这些患者是否会在短期内遭受先前报道的口袋感染问题的困扰。这项研究的目的是就程序性短期结局（包括围手术期和术后并发症）进一步评估我们在单中心研究中连续进行S-ICD植入手术的患者中DM的作用。