Related Experiment Video
Updated: Oct 22, 2025
06:10
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.4K
Arrhythmic and Mortality Outcomes Among Ischemic Versus Nonischemic Cardiomyopathy Patients Receiving Primary ICD
Craig R Narins1, Mehmet K Aktas1, Anita Y Chen2
1Division of Cardiology, University of Rochester Medical Center, Rochester, New York, USA.
JACC. Clinical Electrophysiology
|August 29, 2021
Summary
Patients with ischemic cardiomyopathy have a similar risk of ventricular arrhythmias as those with nonischemic cardiomyopathy. However, ischemic cardiomyopathy patients face a higher risk of all-cause mortality, primarily from non-sudden cardiac causes.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Conflicting data exist regarding the efficacy of primary prevention implantable cardioverter-defibrillator (ICD) therapy in patients with ischemic versus nonischemic cardiomyopathy.
- Understanding these differences is crucial for optimizing patient selection and treatment strategies.
Purpose of the Study:
- To investigate the association between cardiomyopathy etiology (ischemic vs. nonischemic) and the risk of ventricular arrhythmias, appropriate ICD therapy, and mortality.
- To compare outcomes in patients with ischemic cardiomyopathy (ICM) versus nonischemic cardiomyopathy (NICM) receiving primary prevention ICDs.
Main Methods:
- Analysis of data from 4803 patients (3106 ICM, 1697 NICM) enrolled in 5 randomized primary prevention ICD trials (1997-2017).
- Primary endpoint: sustained ventricular tachycardia (VT) ≥200 beats/min or ventricular fibrillation (VF).
- Secondary endpoints: appropriate ICD therapy, all-cause mortality, and cause-specific mortality (noncardiac, sudden cardiac, non-sudden cardiac).
Main Results:
- ICM patients were older with more comorbidities; NICM patients had more advanced heart failure and received more cardiac resynchronization therapy.
- Multivariate analysis revealed similar risks for VT/VF events (HR: 0.98) and appropriate ICD therapy (HR: 1.03) between ICM and NICM.
- All-cause mortality risk was 1.8-fold higher in ICM patients (HR: 1.84), driven by non-sudden cardiac death.
Conclusions:
- In primary prevention ICD patients, ischemic cardiomyopathy is associated with a similar risk of life-threatening ventricular arrhythmias compared to nonischemic cardiomyopathy.
- Ischemic cardiomyopathy patients exhibit a significantly increased risk of all-cause mortality, predominantly due to non-sudden cardiac causes.
- These findings highlight the importance of considering non-arrhythmic mortality risks in ICM patients with ICDs.
More Related Videos
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
10.6K
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
1.1K
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
69
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
69
01:30Cardiomyopathy II: Dilated Cardiomyopathy
84
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
84
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
97
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
97
01:25Cardiomyopathy I: Introduction and Classification
131
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
131
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
121
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
121
01:25Dysrhythmias VI: Management of Dysrhythmias
167
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
167