Survival and appropriate device interventions in recipients of cardioverter defibrillators implanted for the primary versus secondary prevention of sudden cardiac death
PACE - Pacing and Clinical Electrophysiology, cilt.32, sa.SUPPL. 1, 2009 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Özet
- Cilt numarası: 32 Sayı: SUPPL. 1
- Basım Tarihi: 2009
- Doi Numarası: 10.1111/j.1540-8159.2008.02222.x
- Dergi Adı: PACE - Pacing and Clinical Electrophysiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Anahtar Kelimeler: implantable cardioverter defibrillator, sudden cardiac death, ventricular tachyarrhythmia, survival analysis, primary prevention, secondary prevention
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Implantable cardioverter-defibrillators (ICD) implanted after an episode of ventricular tachyarrhythmia (VTA) or in patients at high risk of VTA lower the long-term mortality. Comparisons of the clinical outcomes of the two indications are scarce. Methods: The study enrolled 360 consecutive ICD recipients. The device was implanted for secondary prevention in 150 patients, whose mean age was 60 ± 14 years, and mean left ventricular ejection fraction (LVEF) was 40 ± 16%, and for primary prevention in 210 patients, whose mean age was 61 ± 11 years, and mean LVEF was 31 ± 13%. All-cause mortality and time to first appropriate ICD therapy were measured. Results: The two study groups were similar with respect to age and prevalence of coronary artery disease. Mean LVEF was higher in the secondary prevention group (P = 0.001). Cox regression analysis revealed a significantly shorter time to first appropriate ICD therapy in the secondary prevention group (HR = 0.51, 95% CI = 0.30 - 0.87, P = 0.01). Over a mean follow-up of 37 ± 19 months, the all-cause mortality in the overall population was 12.7%, and was similar in both subgroups (HR = 0.99, 95% CI = 0.55-1.77, P = 0.97). Conclusions: The long-term mortality in this unselected population of ICD recipients was low. Patients treated for secondary prevention received earlier appropriate ICD therapy than patients treated for primary prevention. Long-term mortality was similar in both groups. The higher VT incidence of VTA was effectively treated by the ICD and was not associated with a higher mortality. © 2009, The Authors.