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Prophylactic implantable cardioverter defibrillator therapy in dilated cardiomyopathy: Impact of left ventricular function
- Source :
-
International Journal of Cardiology . Mar2006, Vol. 108 Issue 1, p26-30. 5p. - Publication Year :
- 2006
-
Abstract
- Abstract: Background: The value of an implantable cardioverter defibrillator (ICD) for primary prevention in dilated cardiomyopathy (DCM) is unclear, as randomized trials could not show a survival benefit compared to drug therapy. It has not been investigated if patients with a very poor left ventricular function (LVEF) could profit from an ICD. Methods: Consecutive patients with DCM who received an ICD between December 1996 and November 2003 were included in this analysis. Patients were divided in group A (secondary prevention) and group B (primary prevention). Both groups were stratified in subgroups with left ventricular ejection fraction (LVEF) below and above 20%. Results: Fifty eight patients were included (male 50, age 56.4±12.7 years). Follow-up was 34±19 months. There was no difference regarding death (18% vs. 11%), but significant differences (p value <0.05) regarding any adverse events (55% vs. 22%), any ICD intervention (48% vs. 17%) and ICD interventions for life-threatening arrhythmias (27% vs. 0%) between group A and B. LVEF was not predictive for events in group A, whereas in group B only patients with a LVEF <20% had events (p value 0.02). Over time there was an increase of the LVEF of more than 15% determined by echocardiography in 36% of patients, significantly more often in group B. Conclusions: Indication for primary prevention with an ICD in DCM should be made with caution. Larger studies are needed to determine if patients with LVEF of <20% might benefit from an ICD. [Copyright &y& Elsevier]
- Subjects :
- *MEDICAL equipment
*CARDIOMYOPATHIES
*HEART diseases
*CARDIAC imaging
Subjects
Details
- Language :
- English
- ISSN :
- 01675273
- Volume :
- 108
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- International Journal of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 19912761
- Full Text :
- https://doi.org/10.1016/j.ijcard.2005.03.058