Comparison of Ventricular Tachyarrhythmia Characteristics in Patients With Idiopathic Dilated or Ischemic Cardiomyopathy and Defibrillators Implanted for Primary Prevention
| Autor: | Christian Wolpert, Christian Veltmann, Florian Streitner, Eva Mahl, Martin Borggrefe, Claudia Dietrich, Juergen Kuschyk, Christina Doesch, Ines Streitner, Rainer Schimpf |
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| Rok vydání: | 2011 |
| Předmět: |
Cardiomyopathy
Dilated Male medicine.medical_specialty Ventricular Tachyarrhythmias Electric Countershock Myocardial Ischemia Clinical Investigations Kaplan-Meier Estimate Ventricular Function Left Germany Internal medicine medicine Humans In patient Longitudinal Studies Prospective Studies cardiovascular diseases Aged Heart Failure Chi-Square Distribution Ischemic cardiomyopathy Ejection fraction business.industry Patient Selection Incidence (epidemiology) Stroke Volume Dilated cardiomyopathy General Medicine Middle Aged medicine.disease Defibrillators Implantable Primary Prevention Death Sudden Cardiac Treatment Outcome Heart failure Practice Guidelines as Topic Ventricular Fibrillation Tachycardia Ventricular Cardiology Female Cardiomyopathies Cardiology and Cardiovascular Medicine business Multicenter Automatic Defibrillator Implantation Trial |
| Zdroj: | Clinical Cardiology. 34:604-609 |
| ISSN: | 0160-9289 |
| DOI: | 10.1002/clc.20949 |
| Popis: | Background: Implantable cardioverter-defibrillator (ICD) therapy for primary prevention is well established in ischemic cardiomyopathy (ICM). Data on the role of ICDs in patients with dilated cardiomyopathy (DCM) and no history of ventricular tachyarrhythmia (VT/VF) are more limited. Hypothesis: DCM patients with an impaired left ventricular ejection fraction (LVEF) still represent a low arrhythmic risk subgroup in clinical practice. Methods: ICD stored data of DCM patients with an LVEF ≤35% was compared to data of ICM patients meeting Multicenter Automatic Defibrillator Implantation Trial (MADIT) eligibility criteria. VT/VF occurrences and electrical storm (ES) events were analyzed. Results: There were 652 patients followed for 50.9 ± 33.9 months. There were 1978 VT and 241 VF episodes analyzed in 66 out of 203 patients (32.5%) with DCM and in 118 out of 449 patients (26.3%, P = 0.209) with ICM. Freedom of appropriate ICD treatment due to VT/VF or ES events did not differ in both patient populations (log-rank, P>0.05). In patients presenting with VT/VF episodes, mean event rates were comparable in both patient populations (3.2 ± 14.1 for DCM and VT vs 3 ± 13.9 for ICM and VT [P = 0.855], 0.4 ± 1.3 for DCM and VF vs 0.4 ± 1.8 for ICM and VF [P = 0.763], and 0.2 ± 0.7 for DCM and ES vs 0.2 ± 1 for ICM and ES [P = 0.666]). Conclusions: DCM patients with prophylactic ICDs implanted due to heart failure and patients fulfilling MADIT criteria reveal comparable patterns of VT/VF/ES events during long-term follow-up. Incidence, mean number of events, and time to first event did not differ significantly. Findings support the current guidelines for prophylactic ICD therapy in DCM patients with heart failure. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose. |
| Databáze: | OpenAIRE |
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