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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

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Defibrillator Versus beta-Blockers for Unexplained Death in Thailand (DEBUT): a randomized clinical trial

Koonlawee Nademanee1, Gumpanart Veerakul, Morton Mower

  • 1Pacific Rim Electrophysiology Research Institute, Los Angeles, Cal, USA. wee@pacificrimep.com

Circulation
|April 16, 2003
PubMed

Insights

Sudden Unexplained Death Syndrome (SUDS) patients benefit from implantable cardioverter defibrillators (ICDs). ICDs provided full protection from death related to primary ventricular fibrillation (VF), outperforming beta-blockers in a clinical trial.

Area of Science:

  • Cardiology
  • Clinical Trials
  • Sudden Cardiac Death Research

Background:

  • Sudden Unexplained Death Syndrome (SUDS) is a primary cause of mortality in young, healthy Southeast Asian men.
  • The efficacy of implantable cardioverter defibrillators (ICDs) for reducing mortality in SUDS patients is not well-established.
  • This study addresses the uncertainty surrounding ICD use in SUDS survivors.

Purpose of the Study:

  • To compare the effectiveness of ICDs versus beta-blockers in reducing all-cause mortality in Sudden Unexplained Death Syndrome survivors.
  • To evaluate the impact of these treatments on recurrent ventricular tachycardia/ventricular fibrillation (VF) and cardiac arrest.

Main Methods:

  • The Defibrillator Versus beta-Blockers for Unexplained Death in Thailand (DEBUT) study was a two-phase randomized clinical trial.
  • 86 SUDS survivors and probable survivors were randomized to receive either an ICD or propranolol.
  • The primary endpoint was all-cause mortality, with a secondary endpoint of recurrent VF or cardiac arrest over a 3-year follow-up.

Main Results:

  • During the 3-year follow-up, all 4 deaths occurred in the beta-blocker group (P=0.02).
  • No deaths were observed in the ICD group.
  • Seven patients in the ICD arm experienced recurrent VF, all successfully treated by the device.

Conclusions:

  • Implantable cardioverter defibrillator (ICD) treatment offers complete protection against death from primary ventricular fibrillation (VF) in the SUDS population.
  • ICD therapy is demonstrably superior to beta-blockade treatment for mortality reduction in SUDS patients.
Abstract

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