Introducing ICD-resistant mortality as an end point to evaluate the clinical efficacy of an implantable cardioverter-defibrillator in ischaemic cardiomyopathy

Objective: A new end point called ICD-resistant mortality was evaluated to assess the clinical efficacy of ICD implantations. Methods and results: In 302 ICD patients with ischaemic cardiomyopathy, we investigated which clinical parameters predicted useful ICD implantations using cumulative incidenc...

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Bibliographic Details
Published in:Acta Cardiologica 2018-01, Vol.73 (1), p.19-27
Main Authors: Floré, Vincent, Vandenberk, Bert, Belmans, Ann, Garweg, Christophe, Ector, Joris, Willems, Rik
Format: Article
Language:English
Subjects:
Aged
Belgium - epidemiology
Death, Sudden, Cardiac - epidemiology
Death, Sudden, Cardiac - etiology
Death, Sudden, Cardiac - prevention & control
Defibrillators, Implantable
Electric Countershock - mortality
Female
Follow-Up Studies
Humans
Implantable cardioverter-defibrillator
Incidence
ischaemic cardiomyopathy
Male
Middle Aged
Myocardial Ischemia - complications
Myocardial Ischemia - mortality
Myocardial Ischemia - therapy
Retrospective Studies
Risk Factors
risk stratification
Survival Rate - trends
Treatment Outcome
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Summary:Objective: A new end point called ICD-resistant mortality was evaluated to assess the clinical efficacy of ICD implantations. Methods and results: In 302 ICD patients with ischaemic cardiomyopathy, we investigated which clinical parameters predicted useful ICD implantations using cumulative incidence competing risk analysis. Implantation was deemed clinically useful when the ICD provided appropriate therapy and the patient survived implantation by 1 year and the first shock by 30 days. ICD-resistant mortality (ICDRM) was defined as death within 30 days after the first shock, within 1 year of implantation or without previous appropriate ICD therapy. After 5 years, ICDRM occurred in 23% of implantations, while 36% were clinically useful. After multivariable analysis, ICDRM was associated with LVEF
ISSN:0001-5385
0373-7934
DOI:10.1080/00015385.2017.1322776