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Updated: Jul 16, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Clinical follow-up of patients with implantable cardioverter-defibrillator
Silvia Martelo Souza da Fonseca1, Luiz Gustavo Belo, Hécio Carvalho
1Hospital Universitário Clementino Fraga Filho, Clínica São Vicente, Rio de Janeiro, RJ, Brazil smartelo@openlink.com.br
Insights
Implantable cardioverter-defibrillators (ICDs) effectively treat ventricular arrhythmias in both ischemic and nonischemic heart disease patients. Electrophysiological study selection ensures appropriate ICD therapy and low mortality rates.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening ventricular arrhythmias.
- Patient selection for ICD implantation is critical for optimizing outcomes.
- Understanding therapy appropriateness and complications is essential for clinical practice.
Purpose of the Study:
- To evaluate appropriate (AT) and inappropriate (IT) ICD therapies in patients with ischemic and nonischemic heart disease.
- To assess early and late procedure-related complications associated with ICD implantation.
- To analyze the efficacy of ICDs in diverse patient populations.
Main Methods:
- Analysis of 155 patients (119 male, 36 female) who underwent ICD implantation between 1994 and 2003.
- Patients categorized into four groups: Post-AMI, nonischemic heart disease, arrhythmogenic right ventricular dysplasia, and channelopathies.
- Electrophysiological study (EPS) performed for all patients to induce sustained ventricular arrhythmias prior to ICD implantation.
Main Results:
- A high rate of appropriate ICD therapies (46%) was observed across all patient groups during a 26-month mean follow-up.
- No statistically significant differences in overall (8.4%) or arrhythmic mortality (1.3%) were found among the groups.
- A low incidence of early and late procedure-related complications (4%) was reported.
Conclusions:
- ICD therapy is highly effective in managing ventricular arrhythmias in selected ischemic and nonischemic heart disease patients.
- EPS-guided patient selection is a valuable strategy for improving ICD therapy outcomes.
- ICDs demonstrate a favorable safety profile with low complication rates.
Objective:
To report appropriate (AT) and inappropriate (IT) ICD therapies in patients with ischemic and nonischemic heart disease, as well as early and late procedure-related complications.
Methods:
One hundred and fifty-five patients (119 male and 36 female), mean age 47 years (21-88), who underwent ICD implantation between 1994 and March 2003 were analyzed. Patients were divided into the following groups: Group I--Post-AMI patients (n = 80); Group II--Patients with nonischemic heart disease and LV ejection fraction < 40% (n = 45), Chagas disease (n = 18), idiopathic dilated cardiomyopathy (n= 12), hypertensive disease (n = 8), hypertrophic cardiomyopathy (n = 4) and valvular heart disease (n = 3); Group III--Patients with arrhythmogenic right ventricular dysplasia (n = 13); and Group IV--Patients with channelopathies: Brugada Syndrome (n = 8) and idiopathic ventricular arrhythmias (n = 9). All patients underwent electrophysiological study (EPS) with induction of sustained ventricular arrhythmia ICD implantation.
Results:
During the 26-month mean follow up, a high rate of appropriate ICD therapies (antitachycardia pacing and/or shock) was observed (46%) in the four groups, with no statistically significant difference. The four groups did not differ in either overall (8.4%) or arrhythmic mortality (1.3%). There was no correlation between appropriate ICD therapies and initial clinical presentation or inducible ventricular arrhythmia at EPS, and a 4% incidence of early and late procedure-related complications was found.
Conclusion:
The high incidence of appropriate ICD therapy and low rate of sudden death in the patients studied suggest that ICD is a valuable strategy in the management of ischemic and nonischemic patients previously selected by means of EPS.
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