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Background: Previous studies have demonstrated the lifesaving role of an implantable cardioverter-defibrillator (ICD) in high-risk patients with genetic arrhythmogenic diseases., Aim: To evaluate the clinical data of patients with hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVD/C), idiopathic ventricular arrhythmia (IDIO-VA) including Brugada syndrome, short QT syndrome, and long QT syndrome (LQT) enrolled in the Italian ICD Registry in the years 2001-6., Methods: The survey collected prospectively clinical data and technical characteristics of ICD implants on the basis of EURID form., Results: The number of patients was 1,274 in the HCM group, 520 in the ARVD/C group, 460 in the IDIO-VA group, and 245 in the LQT group. Primary prevention involved 29.5% of patients in the HCM group, 15.9% in the ARVD/C group, 16.9% in the IDIO-VA group, and 16.6% in the LQT group, respectively. Ventricular tachycardia and ventricular fibrillation were reported in 49.0% and 24.8% in the HCM group, 72.9% and 20.0% in the ARVD/C group, 48.2% and 42.9% in the IDIO-VA group, and 21.2% and 61.6% in the LQT group, respectively. Single-, dual-, and triple-chamber ICDs were implanted in 41.5%, 47.6%, and 10.9% in the HCM group; 57.9%, 36.7%, and 5.4% in the ARVD/C group; 55.0%, 45.0%, and 0% in the IDIO-VA group; and 57.4%, 42.6%, and 0% in LQT group, respectively., Conclusion: ICD therapies in the years 2001-6 for patients with inherited arrhythmia syndromes were utilized in Italy in a still-limited number of patients. Secondary prevention represented the major indication for ICD implant and the majority of patients were treated by single-chamber ICDs.

Background: The benefits conferred by implantable cardioverter defibrillators (ICDs) have expanded to primary prevention. The advancements in ICD therapy (ACT) registry in the United States and the Italian ICD registry (IIR) examine changing trends in ICD implantation in their respective countries. Data from these registries may be useful for comparison of transcontinental differences in ICD utilization., Methods: This study includes initial implantations in patients enrolled in ACT and IIR. A comparative analysis was performed for device indications based on primary or secondary prevention. Sub-group analyses by device types (single, dual chamber, or cardiac resynchronization) were performed., Results: This analysis included 4,547 primary implantations in ACT and 6,491 in IIR. The groups were similar with respect to age. There were 82% primary and 18% secondary prevention indications in ACT, versus 42% primary and 58% secondary prevention indications in IIR (P < 0.001). There was a significantly higher rate of dual chamber ICD implants in ACT than in IIR for both primary (35.7% vs 23.7%, P < 0.001) and secondary prevention (52.3% vs 36.9%, P < 0.001). Conversely, more CRT-D were implanted in IIR than in ACT (primary prevention 46.5% vs 32.0%; secondary prevention 29.0% vs 13.0%, P < 0.001)., Conclusions: Significant differences were observed in the types of indications for ICDs between ACT and IIR. Device prescription differed significantly between countries. The specific reasons for differences in ICD implantation patterns in these two countries are unclear. These observations warrant further investigations to determine if these differences are associated with different qualities of life and clinical outcomes.

Background: Several trials demonstrated the lifesaving role of implantable cardioverter-defibrillator (ICD) in high-risk groups of patients. Aim of this review was to report the clinical characteristics of patients enrolled in the ICD Registry of the Italian Association of Arrhythmology (AIAC) in the years 2001-2004., Methods: The Registry collects prospectively 85% of national ICD implantation activity on the basis of European ICD form (EURID)., Results: The number of implanted ICDs in Italy was 2,418 in the year 2001, 3,992 in the year 2002, 5,595 in the year 2003, and 7,190 in the year 2004. The number of ICDs per million of inhabitants was 42.1 in the year 2001 (+11.8% respect to 2000), 70.0 in the year 2002 (+65.1% respect to 2001), 98.3 in the year 2003 (+40.4% respect to 2002), and 125.0 in the year 2004 (+27.2% respect to 2003). The median age was 67 years in the years 2001-2002, 68 years in the years 2003-2004. The main indications during the study were syncope (24.2-14.9%) and cardiac arrest (28.5-17.3%), followed by palpitations and dizzy spells (15.5-17.2%, and 9.4-6.9% of patients, respectively). The use of prophylactic ICD had a fourfold increase in the examined period (5.8% in 2001, 22.9% in 2004). Ventricular tachycardia was the main arrhythmic indication in 44.4-54.6% of cases, ventricular fibrillation in 11.8-18.0%, both in 3.5-6.5%. In the years 2002, 2003, and 2004 single chamber ICDs were implanted in 45.5%, 38.8%, and 33.7% of patients, dual chamber ICDs in 35.1%, 32.3%, and 30.5%, biventricular ICDs in 19.4%, 28.9%, and 34.7%, respectively., Conclusion: The ICD implantation rate in Italy increased significantly in the period 2001-2004, similarly to the trend in other western countries. The Registry showed an important increase of prophylactic and dual or triple chamber ICDs use.