Survival and arrhythmic risk among ischemic and non-ischemic heart failure patients with prophylactic implantable cardioverter defibrillator only therapy: A propensity score-matched analysis

Figuero, S Briongos; Estévez, Agustín; Perez, M L; Martínez-Ferrer, José; García, Enrique; Viñolas, Xavier; Arenal, Ángel; Alzueta, Javier; Basterra, Nuria; Rodríguez, Aníbal; Lozano, Ignacio Fernández; Muñoz‐Aguilera, Roberto

doi:10.1016/j.ijcard.2018.09.003

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Our results, derived from a large cohort followed with daily RM, show that the SVA rate (including VF episodes) was similar between the DANISH‐like patient group and their ischemic counterparts. These findings are consistent with previous registries which found a similar rate of SVAs and ICD therapies between ICM and NICM patients implanted for primary prevention …”

Section: Discussionsupporting

confidence: 93%

“…The underlying assumption whereby ICD‐appropriate therapies are a surrogate for SCD is that episodes of SVAs that are long enough to result in an ICD intervention are likely to have caused SCD. However, not all appropriate and successful shocks are life‐saving because prolonged ventricular arrhythmias may convert spontaneously or may not result in inadequate tissue perfusion …”

Section: Limitationsmentioning

confidence: 99%

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Long‐term outcomes after prophylactic ICD and CRT‐D implantation in nonischemic patients: Analysis from a nationwide database of daily remote‐monitoring transmissions

Forleo¹,

Solimene²,

Pisanò

et al. 2019

Cardiovasc electrophysiol

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Introduction: Clinical trials did not provide conclusive evidence concerning the benefit of prophylactic implantable cardioverter‐defibrillators (ICDs) in patients with severe nonischemic cardiomyopathy (NICM). We aimed to compare incidence of appropriate sustained ventricular arrhythmia (SVA) and device therapy in ischemic cardiomyopathy (ICM) vs NICM ICD and/or cardiac resynchronization therapy (CRT‐D) patients. Methods and Results: We analyzed remote‐monitoring data from devices of the Home Monitoring Expert Alliance network. SVA recordings were adjudicated by three independent electrophysiologists. Our cohort included 1,946 patients who received either an ICD (55%) or a CRT‐D (45%) for primary prevention of sudden cardiac death. Median (interquartile range) age was 70 (62‐77) years, 81% were male, and 52% were in the ICM group. Patients were remotely monitored for a maximum follow‐up of 5 years. The 5‐year product‐limit estimate of SVA incidence in patients with an ICD was 47.3% (95% confidence interval [CI], 41.0%‐53.9%) in the ICM group and 44.7% (36.9%‐53.3%) in the NICM group. In patients with a CRT‐D, SVA incidence was 45.7% (37.3%‐55.0%) in ICM patients and 49.2% (40.4%‐58.7%) in NICM patients. The adjusted hazard ratio for SVA in the ICM vs NICM group was 0.96 (95% CI: 0.70‐1.30, P = .77) in ICD patients and 0.85 (95% CI: 0.61‐1.18, P = .34) in CRT‐D patients. SVAs triggered appropriate device therapies with similar incidence in all groups. Conclusion: In a large cohort of remotely monitored ICD and CRT‐D recipients, SVA incidence did not significantly differ in ICM and NICM patients.

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Section: Discussionsupporting

confidence: 93%

Section: Limitationsmentioning

confidence: 99%