Implantable cardioverter defibrillators for primary prevention in cardiomyopathies

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Indian heart journal Pub Date : 2024-03-01 DOI:10.1016/j.ihj.2024.03.005
Vineetha Kanneganti , Ajay Bahl , Manoj Kumar Rohit , Saurabh Mehrotra
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Abstract

Background

Implantable cardioverter defibrillators (ICD) are often used as primary prevention strategy for sudden cardiac death (SCD) in young individuals. This study analyzed appropriate therapies, complications and inappropriate shocks in the real-world Indian population.

Methods

All patients in the cardiomyopathy cohort under follow up who had ICD implanted as a primary prevention strategy were studied. The objective was to assess the incidence of appropriate ICD therapies, inappropriate therapies and complications. ICD was interrogated and stored electrograms analyzed. Underlying arrhythmia or conditions resulting in appropriate or inappropriate ICD therapy were studied. Correlation and regression studies was done to assess for the predictors of appropriate therapy.

Results

Fifty patients were followed up for a mean follow-up duration of 4.4 ± 3.1 years with total follow up of 220.2 patient years. Appropriate ICD therapy was delivered in 16 out of 50 (32%) patients, with 65 appropriate therapies (median 2 per patient, range: 0–20). Inappropriate therapy delivered in 7 of the 50 (14%) patients, with 44 inappropriate therapies (median 5 per patient, range: 0–20). Complications occurred in 8 of the 50 (16%) patients. Overall, the rate of appropriate therapy was 29.5 per 100 patient years, that of inappropriate therapy was 19.9 per 100 patient years and the rate of complications was 3.6 per 100 patient years.

Conclusions

When implanted for primary prevention in patients with cardiomyopathies over a mean period of 4.4 ± 3.1 years, appropriate ICD therapy was delivered in 32% patients. However, inappropriate therapy (14% patients) and complications (16% patients) were also common.

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用于心肌病一级预防的植入式心律转复除颤器。
背景:植入式心律转复除颤器(ICD)通常被用作年轻人心脏性猝死(SCD)的一级预防策略。本研究分析了现实世界中印度人群的适当疗法、并发症和不当电击:方法:研究随访的心肌病队列中所有植入 ICD 作为一级预防策略的患者。目的是评估 ICD 适当疗法、不适当疗法和并发症的发生率。对 ICD 进行询问并分析存储的电图。研究了导致适当或不适当 ICD 治疗的潜在心律失常或病症。进行了相关性和回归研究,以评估适当治疗的预测因素:对 50 名患者进行了随访,平均随访时间为 4.4 ± 3.1 年,总随访时间为 220.2 年。50 名患者中有 16 人(32%)接受了适当的 ICD 治疗,其中 65 人接受了适当的治疗(中位数为每名患者 2 次,范围:0-20)。在 50 位患者中,有 7 位(14%)接受了不适当的治疗,其中 44 位接受了不适当的治疗(每位患者的中位数为 5,范围:0-20)。50 名患者中有 8 名(16%)出现并发症。总体而言,适当治疗率为每 100 个患者年 29.5 例,不适当治疗率为每 100 个患者年 19.9 例,并发症发生率为每 100 个患者年 3.6 例:结论:在平均 4.4 ± 3.1 年的时间内,为心肌病患者植入 ICD 进行一级预防时,32% 的患者接受了适当的 ICD 治疗。然而,治疗不当(14% 的患者)和并发症(16% 的患者)也很常见。
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来源期刊
Indian heart journal
Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
6.70%
发文量
82
审稿时长
52 days
期刊介绍: Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.
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