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The automatic implantable cardioverter-defibrillator: efficacy, complications and survival in patients with malignant
P A Kelly1, D S Cannom, H Garan
1Cardiac Unit, Massachusetts General Hospital, Boston 02114.
Insights
The automatic implantable cardioverter-defibrillator (AICD) effectively treats life-threatening ventricular arrhythmias with a low risk profile. Survival rates at six and twelve months were high, demonstrating AICD
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Refractory life-threatening ventricular arrhythmias pose a significant risk.
- Automatic implantable cardioverter-defibrillators (AICDs) are a therapeutic option.
Purpose of the Study:
- To evaluate the safety and efficacy of AICD implantation.
- To assess patient outcomes and survival rates following AICD implantation.
Main Methods:
- Ninety-four patients underwent AICD implantation.
- Follow-up averaged 17 months, with analysis of device discharges and complications.
Main Results:
- Forty-six patients experienced appropriate AICD discharges for ventricular arrhythmias.
- Six and 12-month survival rates were 98.7% and 95.4%, respectively.
- Complications included perioperative deaths and arrhythmias.
Conclusions:
- AICD implantation is a highly effective treatment for refractory ventricular arrhythmias.
- The procedure demonstrates a relatively low risk profile for selected patients.
Abstract:
Ninety-four patients underwent surgery for automatic implantable cardioverter-defibrillator implantation. Ninety patients were discharged from the hospital with the device and were followed up for a mean period of 17 +/- 10 months. Forty-six patients experienced at least one discharge of the device under circumstances consistent with a malignant ventricular arrhythmia. One sudden death occurred. Complications included perioperative death (3 patients), post-operative ventricular tachycardia (12 patients) and atrial fibrillation (8 patients), perioperative myocardial infarction (1 patient) and device discharges for sinus tachycardia and supraventricular arrhythmias (17 patients). Six and 12 month survival rates by life table analysis were 98.7 and 95.4%, respectively. Thus, the automatic implantable cardioverter-defibrillator is a highly effective and relatively low risk treatment modality for patients with refractory life-threatening ventricular arrhythmias.