Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death

(1) Background: In patients suffering from heart failure, the main causes of death are either hemodynamic failure, or ventricular arrhythmias. The only tool to significantly reduce arrhythmic sudden death is the implantable cardioverter defibrillator (ICD), but not all patients benefit to the same e...

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Autores principales:	Andreea Maria Ursaru, Antoniu Octavian Petris, Irina Iuliana Costache, Nicolae Dan Tesloianu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	primary prevention of sudden cardiac death non-ischemic cardiomyopathy ischemic cardiomyopathy appropriate ICD therapy mortality rate comparison Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/d09d9434b76d46c29bd2110a555121e5
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spelling	oai:doaj.org-article:d09d9434b76d46c29bd2110a555121e52021-11-25T16:49:26ZComparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death10.3390/biomedicines91115952227-9059https://doaj.org/article/d09d9434b76d46c29bd2110a555121e52021-11-01T00:00:00Zhttps://www.mdpi.com/2227-9059/9/11/1595https://doaj.org/toc/2227-9059(1) Background: In patients suffering from heart failure, the main causes of death are either hemodynamic failure, or ventricular arrhythmias. The only tool to significantly reduce arrhythmic sudden death is the implantable cardioverter defibrillator (ICD), but not all patients benefit to the same extent from these devices. (2) Methods: The primary outcome of this single-center study was defined as cardiovascular death in patients with ischemic and non-ischemic heart failure who have benefited from ICD therapy. The secondary outcomes were death from any cause, sudden cardiac death, ICD-related therapies (appropriate antitachycardia pacing or shock therapy for ventricular tachycardia or fibrillation) and recurrences of ventricular tachyarrhythmias. (3) Results: A total of 403 consecutive ICD recipients—symptomatic heart failure patients with ICD for the primary prevention of sudden cardiac death—were included retrospectively: 59% ischemic cardiomyopathy (ICMP) and 41% non-ischemic cardiomyopathy (NICMP) patients. Within a median follow-up period of 36 months, the incidence of cardiovascular mortality was not significantly different in patients with NICMP and ICMP: the primary outcome had occurred in 9 patients (5.4%) in the NICMP group and in 14 patients (5.9%) in the ICMP group (hazard ratio 1; 95% confidence interval (CI) 0.45 to 2.28; <i>p</i> = 0.97). All-cause mortality occurred in 14 of 166 patients (8.4%) in the NICMP group and 18 of 237 patients (7.6%) in the ICMP group. Sudden cardiac death occurred in two patients (1.2%) in the NICMP group and in four patients (1.7%) in the ICMP group (hazard ratio 0.71; 95% CI, 0.13 to 3.88; <i>p</i> = 0.69). The rate of appropriate device therapies was comparable in both groups. (4) Conclusions: In this study, ICD implantation for primary prevention of sudden cardiac death in patients with symptomatic systolic heart failure was associated with similar rates of cardiovascular and all-cause mortality in patients with ischemic heart disease, and in patients with heart failure from other causes. NICMP and ICMP showed comparable rates of recurrent ventricular tachyarrhythmias and appropriate ICD therapies.Andreea Maria UrsaruAntoniu Octavian PetrisIrina Iuliana CostacheNicolae Dan TesloianuMDPI AGarticleprimary prevention of sudden cardiac deathnon-ischemic cardiomyopathyischemic cardiomyopathyappropriate ICD therapymortality rate comparisonBiology (General)QH301-705.5ENBiomedicines, Vol 9, Iss 1595, p 1595 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	primary prevention of sudden cardiac death non-ischemic cardiomyopathy ischemic cardiomyopathy appropriate ICD therapy mortality rate comparison Biology (General) QH301-705.5
spellingShingle	primary prevention of sudden cardiac death non-ischemic cardiomyopathy ischemic cardiomyopathy appropriate ICD therapy mortality rate comparison Biology (General) QH301-705.5 Andreea Maria Ursaru Antoniu Octavian Petris Irina Iuliana Costache Nicolae Dan Tesloianu Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death
description	(1) Background: In patients suffering from heart failure, the main causes of death are either hemodynamic failure, or ventricular arrhythmias. The only tool to significantly reduce arrhythmic sudden death is the implantable cardioverter defibrillator (ICD), but not all patients benefit to the same extent from these devices. (2) Methods: The primary outcome of this single-center study was defined as cardiovascular death in patients with ischemic and non-ischemic heart failure who have benefited from ICD therapy. The secondary outcomes were death from any cause, sudden cardiac death, ICD-related therapies (appropriate antitachycardia pacing or shock therapy for ventricular tachycardia or fibrillation) and recurrences of ventricular tachyarrhythmias. (3) Results: A total of 403 consecutive ICD recipients—symptomatic heart failure patients with ICD for the primary prevention of sudden cardiac death—were included retrospectively: 59% ischemic cardiomyopathy (ICMP) and 41% non-ischemic cardiomyopathy (NICMP) patients. Within a median follow-up period of 36 months, the incidence of cardiovascular mortality was not significantly different in patients with NICMP and ICMP: the primary outcome had occurred in 9 patients (5.4%) in the NICMP group and in 14 patients (5.9%) in the ICMP group (hazard ratio 1; 95% confidence interval (CI) 0.45 to 2.28; <i>p</i> = 0.97). All-cause mortality occurred in 14 of 166 patients (8.4%) in the NICMP group and 18 of 237 patients (7.6%) in the ICMP group. Sudden cardiac death occurred in two patients (1.2%) in the NICMP group and in four patients (1.7%) in the ICMP group (hazard ratio 0.71; 95% CI, 0.13 to 3.88; <i>p</i> = 0.69). The rate of appropriate device therapies was comparable in both groups. (4) Conclusions: In this study, ICD implantation for primary prevention of sudden cardiac death in patients with symptomatic systolic heart failure was associated with similar rates of cardiovascular and all-cause mortality in patients with ischemic heart disease, and in patients with heart failure from other causes. NICMP and ICMP showed comparable rates of recurrent ventricular tachyarrhythmias and appropriate ICD therapies.
format	article
author	Andreea Maria Ursaru Antoniu Octavian Petris Irina Iuliana Costache Nicolae Dan Tesloianu
author_facet	Andreea Maria Ursaru Antoniu Octavian Petris Irina Iuliana Costache Nicolae Dan Tesloianu
author_sort	Andreea Maria Ursaru
title	Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death
title_short	Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death
title_full	Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death
title_fullStr	Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death
title_full_unstemmed	Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death
title_sort	comparable efficacy in ischemic and non-ischemic icd recipients for the primary prevention of sudden cardiac death
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d09d9434b76d46c29bd2110a555121e5
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Comparable Efficacy in Ischemic and Non-Ischemic ICD Recipients for the Primary Prevention of Sudden Cardiac Death

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