Primary prevention of defibrillator implantation after myocardial infarction: clinical practice and compliance to guidelines

Sjöblom, Johanna; Ljung, Lina; Frick, Mats; Rosenqvist, Mårten; Frykman, Viveka

doi:10.1093/europace/eur354

Cited by 7 publications

(8 citation statements)

References 31 publications

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“…In addition, some studies suggest a lack of efficiency of ICDs to prevent all‐cause mortality when implanted early after MI . As a consequence, most ICDs are implanted distantly from the initial MI . In our study, we found that the combined variable of TWA and TO has a good predictive value for SCD or life‐threatening VA within six months after index MI.…”

Section: Discussionmentioning

confidence: 50%

“…The main finding of our study is that the integrated use of HRT and TWA can be useful in predicting sudden death or life‐threatening VA within 6 months after acute MI. This finding appears of great interest considering that (1) most SCD after MI occur within the first year and (2) numerous ICD implantations are performed more than 1‐year after MI . HRT and TWA might be of interest in identifying patients who could benefit from early ICD implantation.…”

Section: Discussionmentioning

confidence: 90%

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In‐Hospital Heart Rate Turbulence and Microvolt T‐Wave Alternans Abnormalities for Prediction of Early Life‐Threatening Ventricular Arrhythmia after Acute Myocardial Infarction

Arisha

Girerd

Chauveau

et al. 2013

Noninvasive Electrocardiol

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 90%

In‐Hospital Heart Rate Turbulence and Microvolt T‐Wave Alternans Abnormalities for Prediction of Early Life‐Threatening Ventricular Arrhythmia after Acute Myocardial Infarction

Arisha

Girerd

Chauveau

et al. 2013

Noninvasive Electrocardiol

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“…16 However, a delayed decision about ICD after AMI is associated with a lower likelihood of implantation of a potentially life-saving device. 17,18 The aim of this study was to investigate what proportion of patients with reduced LV function after an AMI reached an LVEF >35%, thereby no longer qualifying for ICD treatment. We also investigated the time to improvement to allow earlier identification of possible ICD candidates.…”

Section: Circulationmentioning

confidence: 99%

“…This results suggests that ICD implantation may be considered as early as after 1 month in patients with moderately impaired LVEF regardless of revascularization. Because earlier studies have demonstrated that a delayed decision about ICD after AMI is associated with a lower likelihood of implantation, 17,18 it would be beneficial to offer ICD treatment at the 1-month follow-up.…”

Section: Differences In Lvef Between Echocardiographies 1 Throughmentioning

confidence: 99%

Evolution of Left Ventricular Ejection Fraction After Acute Myocardial Infarction

et al. 2014

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Guidelines advocate primary preventive ICDs for patients with LVEF ≤35% after >40 days after AMI, but a delay of at least 3 months is recommended after revascularization. Implantation of primary preventive ICDs is also recommended for patients with LVEF ≤40%, nonsustained ventricular arrhythmias (ventricular tachyarrhythmias) caused by prior AMI, and inducible ventricular tachyarrhythmias during electrophysiological studies. 13 The optimal timing for ICD implantation has not been evaluated in prospective studies.14 A substudy of Multicenter Automatic Defibrillator Implantation Trial (MADIT) II showed more benefit with ICD in patients with more remote AMI, 15 but post hoc analysis of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) study implicates that the duration after AMI does not modify Background-Implantable cardioverter-defibrillator therapy improves survival in patients with reduced left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI). Although the risk of sudden cardiac death is highest in the first month after AMI, there is no survival benefit of early implantable cardioverter-defibrillator implantation, and the optimal time frame has yet to be established. Thus, the aim of this study was to investigate what proportion of post-AMI patients had improved LV function to such an extent that the indication for implantable cardioverter-defibrillator was no longer present. Methods and Results-Patients admitted for AMI with reduced LVEF (≤40%) were eligible for inclusion. Repeat echocardiographic examinations were performed 5 days, 1 month, and 3 months after the AMI. We prospectively included 100 patients with LVEF of 31±5.8% after AMI. At the 1-month follow-up, 55% had an LVEF >35%. The main improvement in LVEF had occurred by 1 month. The mean difference in LVEF over the next 2 months was small, 1.9 percentage units. During the first 9 weeks, 10% of the patients suffered from life-threatening arrhythmias. Conclusions-Most patients have improved LVEF after AMI, and in the majority, the improvement can be confirmed after 1 month, implying that further delay of implantable cardioverter-defibrillator implantation may not be warranted. The aim of this study was to investigate what proportion of patients with reduced LV function after an AMI reached an LVEF >35%, thereby no longer qualifying for ICD treatment. We also investigated the time to improvement to allow earlier identification of possible ICD candidates. MethodsPatients admitted with AMI at Danderyd University Hospital or Södersjukhuset in Stockholm between November 2010 and December 2013 were eligible for participation in the study if a clinical echocardiography showed an LVEF of ≤40%. An AMI was defined according to the second and third universal definitions of myocardial infarction. 19,20 All clinical echocardiographies of potentially eligible patients were reviewed by a participating research cardiologist with echocardiographic expertise who confirmed that the LVEF was indeed ≤40% according to the modified Simpso...

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“…11 However, recent studies reported that for primary prevention after MI, reassessment of LVEF later on is often not done, potentially leading to over-or underutilisation of ICD, the latter especially in older patients. [12][13][14] Furthermore, the timing of ICD use in real life patients remains scarcely studied.…”

Section: Introductionmentioning

confidence: 99%

Implantable cardioverter defibrillator and survival after out-of-hospital cardiac arrest due to acute myocardial infarction in Denmark in the years 2001–2012, a nationwide study

Winther-Jensen

Kjærgaard

Lassen

et al. 2017

European Heart Journal: Acute Cardiovascular Care

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Cardioverter defibrillator implantation rates in patients surviving an myocardial infarction-out-of-hospital cardiac arrest increased from 14% to 19% over the period. Of the total patient population, 13% had implantation earlier than recommended by guidelines, presumably as primary prevention of sudden cardiac death. Acute PCI and arrest later in the study period (increase one year) were predictors of late cardioverter defibrillator implantation. Early cardioverter defibrillator implantation was significantly associated with a long-term survival benefit, later implantation was not.

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Primary prevention of defibrillator implantation after myocardial infarction: clinical practice and compliance to guidelines

Cited by 7 publications

References 31 publications

In‐Hospital Heart Rate Turbulence and Microvolt T‐Wave Alternans Abnormalities for Prediction of Early Life‐Threatening Ventricular Arrhythmia after Acute Myocardial Infarction

In‐Hospital Heart Rate Turbulence and Microvolt T‐Wave Alternans Abnormalities for Prediction of Early Life‐Threatening Ventricular Arrhythmia after Acute Myocardial Infarction

Evolution of Left Ventricular Ejection Fraction After Acute Myocardial Infarction

Implantable cardioverter defibrillator and survival after out-of-hospital cardiac arrest due to acute myocardial infarction in Denmark in the years 2001–2012, a nationwide study

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