Implantable cardioverter-defibrillators in patients with long QT syndrome: a multicentre study

Abstract

ICD is effective in nearly half the patient population; however, the early and late complication rates are high. Although the number of unnecessary ICD shocks and reimplant procedures may be lowered by modern programming and increased longevity of newer ICD generators, other adverse events are less likely to be reduced.

Implantable cardioverter-defibrillator therapy in patients with congenital long QT syndrome: do we know what we need to know?

“…The importance of continuous b-blocking therapy even after ICD implantation is further supported by this LQTS cohort [2]. Noncompliance to b-blockers was associated with increased risk for adequate ICD therapy.…”

“…This might be of importance in the decision regarding ICD explantation in this young population after one or two event-free battery cycles. Furthermore, older LQTS patients might still be at risk of sudden cardiac arrest, as demonstrated by an ICD intervention after six decades in one patient in this cohort [2]. Conversely, the risk of inadequate ICD discharge is highest in the first two years after implantation.…”

“…In this Polish cohort, a history of cardiac arrest is the predominant indication. This might explain the higher intervention rate of 45% compared to other populations [2].…”

“…A dual-chamber system may be particularly useful in patients with a severe phenotype or multiple episodes despite the above-mentioned management. Notably, a DDD-ICD upgrade was performed in four of the Polish LQTS patients [2].…”

“…There is a lack of randomised, controlled trials in LQTS patients with ICDs, therefore our knowledge is largely based on observational studies and registries. In a direct response to the paucity of available data, in this issue Zienciuk-Krajka et al [2] report on the multicentre Polish experience in 67 LQTS patients followed up for 48 months. This retrospective study identifies risk factors for ICD discharge and supports the results of many single-centre experiences [3] as well as multicentre registries [4][5][6].…”