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Efficacy of implantable cardioverter defibrillator therapy


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  • Efficacy of implantable cardioverter defibrillator therapy

    Copyright 2003 Health & Medicine Week via NewsRx.com and NewsRx.net
    Health & Medicine Week

    November 17, 2003


    LENGTH: 505 words

    HEADLINE: SUDDEN CARDIAC DEATH: Efficacy of implantable cardioverter defibrillator therapy evaluated


       Efficacy of implantable cardioverter defibrillator therapy is evaluated.

       "Risk stratification and effectiveness of implantable cardioverter-defibrillator (ICD) therapy are unresolved issues in hypertrophic cardiomyopathy (HCM), a cardiac disease that is associated with arrhythmias and sudden death," scientists in the United States report.

       "We assessed ICD therapy in 132 patients with HCM: age at implantation was 34 plusmn 17 years, and 44 (33%) patients were aged less than or equal to 20 years. Indications were sustained ventricular tachycardia (VT) or cardiac arrest (secondary prevention) in 47 (36%) patients, and clinical features associated with increased risk for sudden death (primary prevention) in 85 (64%) patients," wrote D.A. Begley and colleagues, National Heart, Lung, and Blood Institute, Cardiovascular Branch.

       "There were six deaths and 55 appropriate interventions in 27 (20%) patients during a mean follow-up period of 4.8 plusmn 4.2 years: 5-year survival and event-free rates were 96% plusmn 2% and 75% plusmn 5%, respectively. ICD intervention-free rates were significantly less for secondary than for primary
    prevention: 64% plusmn 7% versus 84% plusmn 6% at 5 years, p=.02," the researchers wrote.

       "Notably, 59 of 67 events (cardiac arrest and therapeutic ICD interventions), or 88%, occurred during sedentary or noncompetitive activity. Incidence of therapeutic shocks was related to age but not to other reported risk factors, including severity of cardiac hypertrophy, non-sustained VT during Holter monitoring, and abnormal blood pressure response to exercise," the researchers stated.

       "ICD-related complications occurred in 38 (29%) patients, including 60 inappropriate ICD interventions in 30 (23%) patients. However, eight (27%) of the patients with inappropriate shocks also had therapeutic interventions," they added.

       The researchers concluded: "ICD is effective for secondary prevention of sudden death in HCM. However, selection of patients for primary prevention of sudden death, and prevention of device related complications require further refinement."

       Begley and colleagues published their study in Pacing and Clinical Electrophysiology (Efficacy of implantable cardioverter defibrillator therapy for primary and secondary prevention of sudden cardiac death in hypertrophic cardiomyopathy. Paceing Clin Electrophysiol, 2003;26(9):1887-1896).

       The publisher's contact information for the journal Pacing and Clinical Electrophysiology is: Blackwell Futura Publishing, Inc., 350 Main Street, Malden, MA 01248-5018, USA.

       The information in this article comes under the major subject area of Medical Devices.

       This article was prepared by Health &  Medicine Week editors from staff and other reports.


    LOAD-DATE: November 14, 2003

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