Medtronic’s extravascular ICD is pushing innovation

In October 2019, Medtronic launched a study evaluating their extravascular implantable cardioverter-defibrillator (Ev-ICD) in up to 400 patients in Europe, Australia, New Zealand, Asia and the Middle East.

ICDs are a fast-growing market, primarily driven by the increasing prevalence of arrhythmia as well as advances in technology by combining the features of a traditional pacemaker into the devices. GlobalData estimates there were over 200,000 ICDs implanted globally in 2018, with traditional single- and dual-chamber ICDs growing at an average compound annual growth rate of 5%.

Traditional ICDs and pacemakers require leads that are fed through the vessel and into the heart, which are the most common causes of complications including lead displacements, infections, or the need for lead extraction. To address these complications, Boston Scientific entered the market with an innovative subcutaneous ICD (S-ICD), the Emblem. Being slightly larger than a traditional ICD, the Emblem’s lead is implanted just under the skin above the sternum, eliminating the placement of leads in the heart. The S-ICD market is currently the fastest-growing segment, where GlobalData expects the market to grow at a CAGR of 11% over the next 10 years.

As the need to reduce post-operative complications in traditional ICDs increases, Medtronic’s Ev-ICD may become Boston Scientific’s next competitor in the market for non-transvenous ICDs. Rather than having a lead placed on top of the sternum, the Ev-ICD’s lead would be placed underneath the sternum, in addition to having the ability to deliver bradycardia pacing and anti-tachycardia pacing, which S-ICDs are not able to do. The Ev-ICD’s design is also smaller and longer-lasting, like traditional ICDs, advantages over the S-ICD.

GlobalData expects that, should the study show promising results, Boston Scientific will face fierce competition from Medtronic’s entry into the market.

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